Feb
02
2019

Hormones Helping In Menopause

By | Alzheimer’s disease, heart attack, Hormones, Menopause, Stroke

Dr. Filomena Trindade presented a talk about hormones helping in menopause. This talk was part the 26th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas from December 13 to 15, 2018. The exact title of her talk was “Women and cognition: insulin, menopause and Alzheimer’s”. Above the age of 80 Alzheimer’s disease in women becomes much more common compared to men. PET scans of the brain of postmenopausal women in comparison to PET scans of premenopausal women, often show more than 30% slow down of metabolism after menopause. Literature regarding that finding showed that it was mostly the decline in ovarian estrogen production that was responsible for the slow down in brain metabolism. Other factors that lead to Alzheimer’s disease are central adiposity (abdominal) and inflammation in the body.

Brain insulin resistance and Alzheimer’s

Older women with Alzheimer’s have more IGF-1 resistance and IGF-1 dysfunction. Other studies showed that minimal cognitive impairment (MCI) progressing into Alzheimer’s disease (AD) might be due to type-2 diabetes. One of the studies stated the following:

“We conclude that the term type 3 diabetes accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 DM and type 2 DM.“

Another publication said that type 3 DM is a neuroendocrine disorder that represents the progression of type 2 DM to Alzheimer’s disease.

Dr. Trindade presented several hormone studies in postmenopausal women who started to develop Alzheimer’s disease. Older women with existing Alzheimer’s did not respond to estrogen hormone replacement. They did not recover with regard to their memory loss. However, younger women who just entered menopause responded well to estrogen hormone replacement and many recovered from their memory loss.

Hormone changes in menopause

There are a number of hormones that experience changes with the onset of menopause. Estrogen production ceases in the ovaries. The production of progesterone in the ovaries also ends. In addition thyroid and adrenal gland hormone production decreases. Often insulin production is increased, but insulin resistance is present at the same time.

Stress can interfere with progesterone and aldosterone production as pregnenolone is the same precursor molecule for both hormones.

How stress interferes with Selye’s general adaptation syndrome

Stage 1 of Selye’s adaptation syndrome, called arousal, involves elevation of cortisol and DHEA. When stress is over, the patient recovers on his/her own.

Stage 2 is the adaptation stage, where cortisol is chronically elevated, but DHEA is declining. The patient feels stressed, has anxiety attacks and may experience mood swings and depressions.

Stage 3 is the exhaustion stage. The underlying cause of this stage is adrenal insufficiency. Both cortisol and DHEA blood levels are low. Patients often suffer from depression and chronic fatigue.

Other hormones and menopause

DHEA and cortisol (stress) have the same precursor (pregnenolone). This means that when a patient is stressed, DHEA production tends to suffer as most of the pregnenolone is used for the production of cortisol.

Dr. Trindade spent some time explaining the complicated details of thyroid hormones during menopause. In essence stress can interfere with the normal metabolism of thyroid hormones with respect to T3, T4 and reverse T3. The end result is that not enough functioning thyroid hormones are present and hypothyroidism may develop.

Both estrogen and progesterone are lower in menopause. In a longitudinal French study with over 80,000 postmenopausal patients the women that received replacement with bioidentical progesterone and estrogen did the best in terms of low Alzheimer’s rates and lower heart attack rates. You achieve optimal Alzheimer’s prevention best starting hormone replacement at the time when menopause starts. You need both estrogen to control hot flashes and to give you strong bones, and progesterone for preservation of your brain, your hair growth and a good complexion.

Hormones Helping In Menopause

Hormones Helping In Menopause

Conclusion

Hormones are missing in menopause and this becomes the starting point for many postmenopausal complaints of patients. The sooner the physician does blood tests to diagnose hormone deficiencies, the better. Various studies showed that the best result in terms of Alzheimer’s prevention is possible, when estrogen and bioidentical progesterone are replaced right at the beginning of menopause. This approach prevents neuroinflammation. There are no extracellular beta amyloid protein deposits and no intracellular tau protein deposits that typically are present with Alzheimer’s disease. In addition the cardiovascular system stays healthier for longer. It contributes to preventing heart attacks and strokes. A longitudinal French study with over 80,000 women who have received treatment with a combination of estrogen and bioidentical progesterone have excellent survival data. The women also enjoy excellent mental health, no cardiovascular complications and less cancer than controls without hormone treatment.

 

Jan
19
2019

Alzheimer’s disease is treatable with hormones

By | Alzheimer’s disease, Hormones, neurological disease, Nutrition, Parkinson’s disease, Prevention, testosterone

Dr. Thierry Hertoghe, an endocrinologist from Belgium, stated that Alzheimer’s disease is treatable with hormones. This talk was part the 26th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas (from December 13 to 15, 2018).

First of all, Dr. Hertoghe treated many Alzheimer’s patients himself and noted that they often have multiple hormone deficiencies. Secondly, common deficiencies affect thyroid hormones, human growth hormone, estradiol for women and testosterone for men. But even vasopressin and oxytocin are hormones that may be lacking. Third,  after doing thorough blood tests to assess hormone levels, Dr. Hertoghe replaced what hormones were missing. Finally, many Alzheimer’s patients got their energy, muscle strength and memory back.

In the following I am summarizing what Dr. Hertoghe told the audience about the various hormones. Alzheimer’s disease is treatable with hormones. Later I provide the hormone doses that Dr. Hertoghe uses for replacement.

Progressive memory loss

Generally, patients who develop Alzheimer’s disease start losing short-term memory first, but in time they will also lose long-term memory. Often this disease process starts in the 60’s as age-associated cognitive impairment. In the 70’s it may progress further to mild cognitive impairment, only to take off in the 80’s as Alzheimer’s disease. The astute clinician may order some screening blood tests in the 60’s and 70’s. In a male low testosterone, low DHEAS and low thyroid hormones may be present. Certainly, blood tests will show this readily. Frequently, in women low estradiol, low thyroid and low DHEAS may also be present. The reason this is important is that simple hormone replacement can return a person back to normal. Yes, this is right: hormone replacement can bring a person with age-associated cognitive impairment or mild cognitive impairment back to normal! In other words, Alzheimer’s disease is treatable with hormones.

Hormones important to monitor with Alzheimer’s disease

There are 6 hormones that are important for memory restoration in Alzheimer’s patients: IGF-1 (and growth hormone), thyroid hormones, estrogen and testosterone, vasopressin (and oxytocin) and pregnenolone. However, as Alzheimer’s patients often have sleep problems, another important hormone is melatonin.

Oxytocin to calm down aggressive Alzheimer’s patients

Notably, Dr. Hertoghe found that Alzheimer’s patients often are restless and can be aggressive. This makes it difficult to care for them in a home. Oxytocin is the hormone of trust, affection, sociability and concerns about others. It calms down aggressiveness. But with oxytocin treatment the Alzheimer’s patient feels better, becomes friendly, cooperative and warm-hearted.

As an illustration Dr. Hertoghe gave an example of one of his 80-year old patients with aggressive Alzheimer’s disease. She became unmanageable for her non-married son and other contacts. 5 IU of oxytocin sublingually changed this woman into a friendly, compassionate, warm-hearted woman, and the aggressiveness disappeared completely.

Insomnia in Alzheimer’s patients

About 45% of Alzheimer’s patients develop “sundowning”. When the sun goes down they start getting hyperactive, develop unacceptable behaviors and they become restless. Research papers showed that blood melatonin levels are low in these patients. Indeed, this is why they respond very well to small amounts of melatonin at bedtime. As a conclusion, within only a few days of starting this, their sundowning disappears, and they become easier to look after.

Dr. Hertoghe provided material from several research papers that showed that Alzheimer’s patients are often deficient for melatonin. Replacement with varying doses of melatonin solved even more complicated insomnia problems.

Melatonin is a powerful anti-oxidant. Interesting animal experiments have shown that melatonin has memory-enhancing properties. Researchers believe that melatonin improves the extracellular senile plaques with amyloid-beta peptide accumulation (first of 2 Alzheimer’s lesions). In addition melatonin also decreases the intracellular neurofibrillary degeneration tangles, the second of the two specific Alzheimer’s lesions.

IGF-1 and human growth hormone

Several studies have shown that Alzheimer’s patients have a significant drop in IGF-1 levels and growth hormone levels. This affects their short-term and long-term memory. Serum IGF-1 has an inverse correlation with cognitive impairment. Dr. Hertoghe said that IGF-1 treatment in Alzheimer’s patients increases their brain volume, increases the functional network of neurons in the brain and increases memory.

Brain atrophy in Alzheimer’s patients from chronically depleted IGF-1

Dr. Hertoghe showed a slide of a normal brain with a view from the outside and a cross section view of the brain. The same slide contained the view of an Alzheimer’s patient’s brain. It showed brain atrophy resulting in a much smaller brain and the cross section displayed an increase of the hollow spaces (e.g. the third and forth ventricle). He stressed that in his view the brain shrinkage of Alzheimer’s patients is due to prolonged low levels of IGF-1. This in turn is due to a lack of production of human growth hormone.

With IGF-1 treatment the serum IGF-1 was increasing and the cognitive function in older adults recovered. Dr. Hertoghe provided many literature citations to support this, which I will not repeat here.

Case report of a male patient with Alzheimer’s disease

Dr. Hertoghe presented one of his patients with Alzheimer’s. Lab tests showed that he had deficiencies of thyroid hormones, DHEA and testosterone. But despite replacement of these hormones he remained severely affected with Alzheimer’s. He did not remember his own name, could not go to the toilet on his own, spoke only a few words and suffered from severe fatigue. He received 4 injections around his eyes with IGF-1 and mesotherapy from his doctor (described below) with human growth hormone and IGF-1. Within a few weeks he had a complete reversal of his cognitive decline. He could return to his professional driving career doing halftime work with a delivery van in the city. He could read a newspaper and understood what he was reading. Alzheimer’s disease is treatable with hormones.

Thyroid hormones

According to Dr. Hertoghe thyroid hormones help to establish short-term and long-term memory and treat the apathetic depression in Alzheimer’s patients. Many Alzheimer’s patients are hypothyroid.With this deficiency they have swollen lower eyelids, a puffy face and paleness of the face. In a 1990 study a group of Alzheimer’s patients had 26% lower T3 levels when compared to normal controls. Many patients with hypothyroidism have memory loss, before their deficiency is corrected. Dr. Hertoghe stated that 13% of all dementia cases are reversible by proper thyroid hormone treatment.

Estradiol can improve long-term memory loss

Research showed that estradiol could improve long-term memory in dementia and Alzheimer’s disease cases. Many female Alzheimer’s patients are deficient in estrogens. If they do, they have dry eyes, a pale face and thin, dull hair. In a 2005 study 33 control women were compared to 48 women with Alzheimer’s disease. The estradiol levels in the Alzheimer’s disease group showed significant depletion compared to the normal control group. There was no significant difference found with regard to progesterone, testosterone and LH&HSH levels. Another study showed that in cerebrospinal fluid of women with Alzheimer’s disease the estradiol level was significantly reduced while the beta-amyloid levels were significantly increased.

Dr. Hertoghe reviewed several studies that showed that symptoms of Alzheimer’s disease disappeared with estradiol supplementation. Both memory and mood responded to the treatments.

Men with Alzheimer’s disease are often testosterone deficient

Testosterone is important for long-term memory. Men in andropause report erectile dysfunction, general weakness and memory loss. The physician needs to be aware that the patient may be starting to develop Alzheimer’s disease. Dr. Hertoghe showed a slide based on a publication, which stressed that testosterone enhances memory. It increases brain blood flow and thickens the myelin sheets. Testosterone increases dendrite and synapses and in addition decreases amyloid beta-peptide production. Neurotoxicity is also reduced. The end result is improvement of Alzheimer’s in males with testosterone replacement.

Pregnenolone improves short-term memory

Pregnenolone gets synthesized in the brain, spinal cord and peripheral nerves. Dr. Hertoghe said that pregnenolone is a neurostimulating “neurosteroid”. Pregnenolone concentrations in brain tissue are about 25- to 35-fold higher than in the blood stream. Some cases of Alzheimer’s disease can come from a lack of pregnenolone and pregnenolone sulfate. Patients who have Alzheimer’s because of a lack of pregnenolone have blood levels that are 2.5-fold lower than pregnenolone levels in normal controls. When these patients are treated with pregnenolone, their memory improves. The mechanism of the effect of pregnenolone is by increasing acetylcholine by more than 50% in the hippocampus. It also protects the hippocampus from glutamate and amyloid beta. Pregnenolone improves short-term memory over a period of 3 to 4 months of treatment.

Vasopressin improves short-term and long-term memory loss

Postmortem studies on Alzheimer’s patients showed that there is decreased vasopressin in the brain cortex. In patients with alcoholic dementia (Korsakoff psychosis after recovery) there was decreased vasopressin in the cerebrospinal fluid. Often patients with diabetes insipidus have decreased vasopressin and are in danger of developing dementia. If not treated, they develop short-term and long-term memory loss. When treated with vasopressin or Desmopressin their memory recovers within 4 hours of starting therapy. Younger patients (50 to 73) do better with memory recovery than older patients (74 to 91).

Treatment details of hormone replacement for Alzheimer’s disease

Before hormone treatments are given to a patient it is important to do a battery of blood tests. This will help the physician to identify the missing hormones in a particular patient. Each of the missing hormones are then administered separately.

Oxytocin

This hormone can be given sublingually or intranasally. Sublingually 5-10 IU are given daily. With the sublingual approach 1 or 2 sprays are given daily. Each spray contains 8 IU of oxytocin. Improvement is visible within 2 to 5 days. A full recovery takes 2 to 3 months.

Melatonin

Most patients in the higher age group do no longer produce their own melatonin. With the oral route 1-3 mg are given every night before going to bed. An alternative is to use sublingual tables 0.5mg to 1.0mg at bedtime. The first improvement can be seen 2-5 days after the start of replacing melatonin, the full impact takes about 2-3 months from the start of the treatment.

IGF-1 and human growth hormone

Replacement of IGF-1 can be done by injecting IGF-1 or human growth hormone (HGH). HGH stimulates the liver to produce IGF-1. IGF-1 is somewhat cheaper than HGH. When IGF-1 is used, 0.3mg to 1mg is injected at bedtime. Progress is slow; the first improvement is visible at 2-4 months, it takes up to 24 to 36 months for a full recovery.

For severe memory impairment with Alzheimer’s, the doctor does a double treatment approach with both IGF-1 and HGH: first subcutaneous IGF-1 injections around the eyes 4 times per day (0.01mg each). Secondly, at the doctor’s office the doctor administers mesotherapy injections with 1mg of HGH and 1mg of IGF-1 and vasodilators 3 times per week. Two weeks later the doctor administers another course of mesotherapy. He may repeat this twice in 14-day intervals. Now the interval increases to monthly therapy for 3 months and finally every 3 to 4 months. The patient can use IGF-1 nose drops instead of subcutaneous IGF-1 injections.

Thyroid hormones

Dr. Hertoghe prefers desiccated animal thyroid hormone replacement as the T3/T4 ratio is best matched to what the ratio is in humans. Depending on the severity of thyroid hormone deficiency the patient takes 30-150mg of thyroid hormone every morning. Dr. Hertoghe starts with a low dose and slowly increases the dosage. Clinical progress is very slow. It takes until the second month before the first improvement takes place. Full improvement can take 8-12 months.

Estradiol

Replacement of estradiol in postmenopausal women with Alzheimer’s disease received ether more than 0.1mg per day or 0.625mg of conjugated equine estrogen daily. In both cases there were improvements of their memory and improvement on the Hamilton depression scale.

Dr. Hertoghe’s preferred way to treat postmenopausal women with Alzheimer’s disease is as follows. The first 25 days of each month he gives them 1-2mg of oral estradiol valerate each day and 100mg of micronized progesterone. If they prefer an estrogen cream, he gives them 1-3mg per day transdermal estradiol and 100mg micronized progesterone capsules.

The first improvement is visible after 2-4 months; there is further improvement the next 8-12 months.

Testosterone

There are two methods of how to do hormone replacement with testosterone, either by injection or as transdermal cream. The injection treatment uses 250mg of testosterone enanthate or cypionate every 2 -3 weeks. The patinet can also self-administer testosterone enanthate (50mg twice per week) for a more even blood level of testosterone. The transdermal approach involves 100-250mg transdermal, nanoliposomal testosterone daily.

The memory will improve 2-4 months into replacement therapy. The full improvement takes 8-12 months.

Pregnenolone

The replacement therapy is 100mg per day in the morning for the first 4 months. Then there is a dosage reduction to 50mg daily. Studies have shown that 30mg of pregnenolone is not enough to treat memory loss. Short-term memory improved after 3 to 4 months in about 75% of patients.

Vasopressin

The best vasopressin preparation to use is bio-identical vasopressin. It comes as 1 nasal spray with 10IU of vasopressin. Upon awakening the patient or caregiver applies 1-2 sprays into the nose. The patient receives the second dose 10 minutes before lunch by nasal spray.

Apart from hormones, lifestyle changes are also recommendable.

Alzheimer’s disease is treatable with hormones

Alzheimer’s disease is treatable with hormones

Conclusion

Who would have thought that Alzheimer’s disease could have anything to do with hormones? Dr. Hertoghe, the endocrinologist from Belgium did many hormone tests on Alzheimer’s patients and concluded that various degrees of hormone deficiencies can indeed cause Alzheimer’s disease. But what is more is that you can replace the missing hormones and see complete cures in patients with Alzheimer’s disease. Alzheimer’s disease is treatable with hormones. This is something conventional medicine can only dream of. At this point this hormonal approach is not yet mainstream medicine; but it would not be a surprise to me, if in 10 or 20 years interested physicians do this type of therapy routinely in their practice. When hormones are missing, replace them. When the memory is fading, think about testing for missing hormones! It will make a difference in the quality of life for the patient as well as for his family.

Mar
25
2017

How Stress Affects Our Hormone System

By | Alzheimer’s disease, Anti-aging medicine, autoimmune disease, Cancer, Cardiovascular disease, Diabetes, fractures, Heart Disease, Hormones, immune system, Inflammation, Nutrition, Obesity, stress, thyroid disease

Dr. Andrew Heyman gave a detailed talk recently about how stress affects our hormone system. He presented his talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman stressed in particular that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). It seems like we need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can markedly derail, we develop obesity and fatigue. But when balanced we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. Likewise, he stated that a number of different factors could influence the hormone system:

  • Diet: trans fats, sugar, too many carbs, food allergies.
  • Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
  • Physical exercise: frequency and type matters.
  • Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
  • Stress: physical stress, psychogenic stress.
  • Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
  • Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

  • Pancreas, where blood sugar can rise because of insulin resistance. In particular, too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
  • Thyroid gland, which depends on TSH (thyroid stimulating hormone) for activation. Autoantibodies can also affect it negatively.
  • Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.
  • Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
  • Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, in addition causing inflammation and autoimmune reactions.
  • Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. A brain under stress activates the hypothalamus. It sends a cascade of activating hormones via the pituitary gland and likewise activates the adrenal glands. Finally this leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can finally develop from this.

Hypothalamus/pituitary/adrenal glands activation and clinical effects

The main hormone axis of the stress reaction goes first from the hypothalamus, secondly via the pituitary gland and thirdly to the outside surface of the adrenal glands, which produces cortisol. The term for this is the HPA axis. Stressed people, therefore, make too much cortisol, which weakens immune functions, reduces human growth hormone production, increases belly fat, increases blood pressure and reduces insulin action. In addition, stress also reduces estrogen production in women and testosterone production in men.

Accordingly, the final clinical presentation is osteopenia, then osteoporosis with spontaneous fractures of bones. In addition there is also cardiovascular disease leading to heart attacks and strokes, and cognitive decline with memory loss. There are complications with infections. Also the metabolic syndrome can lead to obesity and type 2-diabetes.

Stress and the hippocampus

In the center of our brain there is a memory-processing unit, the hippocampus that converts short-term memory into long-term memory. Repeated stress interferes with normal hippocampus function. Indeed, high cortisol levels interfere with the proper functioning of the hippocampus causing memory problems.

Hippocampus atrophy can come from chronically high cortisol levels due to chronic stress. In addition this can lead to Alzheimer’s disease.

Effects of chronic stress

Chronic stress leads to cardiovascular disease, to diabetes, chronic inflammation, Alzheimer’s disease, thyroid disorders, cancer, neurological disorders and autoimmune diseases. Researchers showed that inflammation releases tumor necrosis factor-alpha (TNF-alpha), which is a key player of chronic inflammation. This, however leads to the release of other inflammatory kinins like IL6 and others. The resulting chronic inflammation can cause Crohn’s disease, rheumatoid arthritis, insulin resistance, dementia, metabolic syndrome, obesity and atherosclerosis with associated markers (decreased HDL, increased LDL, CRP and triglycerides).

Hormone imbalance causes disease

  1. Excess cortisol production from stress leads to Th2 type inflammatory kinins; usually associated with this is a reduction of DHEA (a male hormone in the adrenal glands), which leads to reduced Th1 type kinins. Overall, the end result is chronic inflammation. When chronic stress has tired out the adrenal glands, a four-point salivary cortisol level test shows a flat curve. This indicates adrenal gland fatigue or, if worse, even adrenal gland insufficiency. Most noteworthy, patients with leukemia, breast cancer, uterine cancer, prostate cancer, pituitary gland cancer and lung cancer show such a pattern.
  2. The disregulation of the HPA axis is particularly evident in patients with metabolic syndrome. People who have this syndrome have a high morning serum cortisol level. As a matter of fact, high cortisol increases the risk to develop metabolic syndrome.
  3. Metabolic connections: high cortisol leads to a partial blockage of thyroid hormones, which in turn leads to hypothyroidism. Hypothyroidism will affect glucose tolerance, and if not treated leads to type 2 diabetes.

In a large study involving 46,578 members of Kaiser Permanente Northwest it was determined that for every 1 point above a fasting glucose level of 84 mg/dL there was an additional 6% risk to develop type 2 diabetes over the next 10 years.

Pathological hormone disturbances

Dr. Heyman mentioned the following hormone patterns that he discussed in detail, increased cortisol levels, increased insulin levels and decreased thyroid levels.

Elevated cortisol

Prolonged elevation of cortisol leads to atrophy of the hippocampus with brain atrophy and Alzheimer’s or dementia. The immune system gets altered, there is lower DHEA hormone leading to weaker muscles and weakened immunity. There is insulin resistance (decreased insulin sensitivity), decreased serotonin and increased depression. Carbohydrate cravings lead to weight gain (central obesity). Changes in the thyroid metabolism leads to hypothyroidism.

Increased insulin level

People who develop high insulin levels are usually sugar or carbohydrate addicts. As they gain weight they change their metabolism into the metabolic syndrome. The extra insulin that is floating around triggers the insulin receptors to become less sensitive (also called “resistant”). The people love to eat. They snack frequently on protein bars and candy bars. As they gain weight, consequently their energy goes down and as a result they often develop painful joints. This prevents them from being physically active. They notice episodes of foggy thinking. Women complain of frequent yeast infections.

The body tries to compensate by slightly decreasing thyroid hormones and slightly increasing cortisol levels.

Decreased thyroid levels

There is increased lactic acid production and decreased insulin sensitivity. Oxidative stress is increased. The patient is depressed and cognition and memory are reduced. Also, the gut has slower motility. The mitochondria, the energy packages in each cell are reduced and functioning less productively. Cardiac function is reduced.

The body tries to compensate for the primary thyroid weakness by slightly elevating insulin and cortisol.

Treatment of stressed hormone system

Before the doctor can treat a disbalanced hormone system, blood tests have to be done that show what kind of hormone constellation is present. Dr. Heyman suggested the following support with supplements.

Treatment of thyroid disorders

Thyroid supplementation may involve any of these: Selenomethionine, iodine, chromium, thyroid glandular, tyrosine, ferritin, Ashwagandha, coleus forskohlii, 7-keto DHEA, ferritin and iron. Other possible supplements that were mentioned by Dr. Heyman were Rhodiola, schisandra, ginseng, Rg3, eurycoma longifolia, neuromedulla glandular, DHEA, tryptophan/5 HTP, licorice, Cordyceps.

This, however, is not all. Missing thyroid hormones need replacement with a balanced T3/T4 medication like Armour thyroid.

Adrenal support

The following supplements are used to support adrenals: Adrenal glandular, vitamin C, adrenal cortex extract, Holy Basil, Pharma GABA, Magnolia/Phellodendron, L-theanine, sterols & sterolins.

Pancreatic support

These supplements support the insulin production in the pancreas:

Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil, micro PQQ, bitter melon, cinnamon, arginine, vanadium, benfotiamine (synthetic derivative of B1 vitamin) and Bergamot.

Dr. Heyman completed his talk by giving a few patient examples, explaining what blood tests showed, what the hormone disbalance was, and which treatment options were helpful.

How Stress Affects Our Hormone System

How Stress Affects Our Hormone System

Conclusion

Dr. Andrew Heyman gave a talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. He talked about how stress in due time affects our hormone system. Symptoms from stress can stem from different causes including hormone disbalances. Given these points, conventional medicine would simply treat the symptoms. However, this will not be successful with stress-induced hormone disbalances, namely, because it does not treat the causes. Obviously only causal treatment of the hormone disbalance will restore the person’s wellbeing and the symptoms will disappear at the same time. In short, anti-aging medicine and integrative medicine are attempting to follow this approach.

Feb
25
2017

Heart Health Improves With Hormone Replacement

By | Alzheimer’s disease, andropause, Anti-aging medicine, Cardiovascular disease, Diabetes, Health, heart attack, Heart Disease, High Blood Pressure, Hormones, Inflammation, Menopause, mitochondria, Mortality, Obesity, Prevention, prostate cancer, stress, Stress management, Stroke

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

First of all, estrogens are the main female hormones in women that protects them from heart attacks.

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. Postmenopausal women who do estrogen replacement therapy (ERT) are helping to reduce their heart attack rates.

Difference between oral and transdermal estrogen replacement

The liver metabolizes estrogen taken by mouth. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained using many slides how estrogen prevents heart attacks. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. The production of Premarin involved pregnant mares. In other words, it is not human estrogen and it does not fit the human estrogen receptors. Also the liver metabolizes estrogen taken as tablet form, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. Postmenopausal women on ERT reduce their physical and emotional stress response compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. No proinflammatory metabolites occur in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. There was an increase of venous thromboembolism in women who took oral estrogen.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Furthermore, progesterone is the second most important female hormone, the importance of which has been neglected in the past. Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Finally, testosterone is the third sex hormone that is present in women. In men it is the main hormone, but women benefit from just a small amounts of it for libido, clarity of thought and muscle endurance.

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician replaces first with bioidentical estrogen; only then does he consider replacing missing testosterone in women. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone ca cause high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone can cause diabetes and metabolic syndrome, which in turn can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. This may be due to rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Researchers sh0wed that bioidentical testosterone does not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

The adrenal glands produce the hormone dehydroepiandrosterone (DHEA). It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial.

Hormone effects on heart muscle

Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart. Physicians can  use them therapeutically in chronic heart failure patients. When people age, their hormone glands will produce less hormones, but blood tests will show this. Replacing hormones that are missing can add years of active life. Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

Feb
06
2016

Effects Of Hormones On The Heart

By | Alzheimer’s disease, Anti-aging medicine, Cardiovascular disease, heart attack, Heart Disease, High Blood Pressure, Hormones, Mortality, Nutrition, Prevention

Since February is heart month, this is a good time to discuss the effects of hormones on the heart. I believe that this is a timely topic to understand how we can protect ourselves from heart disease. During the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 11-13, 2015 in Las Vegas Dr. Ron Rothenberg gave a talk entitled ”Hormones And The Heart”. He stated that he wanted to give an overview of the effects on the endocrine system and on the cardiovascular system, in particular the effect of testosterone and estrogen. Also discussed were the effects of thyroid hormones, growth hormone, vitamin D and melatonin. In the following I will summarize what he explained in detail.

Testosterone treatment in men

He stated that there has been some confusion about the protective effect of testosterone on the heart in men. But Dr. Sharma and colleagues who investigated 83,010 male veterans with documented low testosterone levels clarified this confusion with this large study.

One group received testosterone replacement therapy, another did not receive replacement therapy and one group received replacement with testosterone, but the testosterone levels did not normalize.

Mortality reduction with testosterone replacement

The observation time for the various groups was between 4.6 years and 6.2 years. The results were impressive. A comparison between the results of men on testosterone replacement and the results of men without testosterone replacement, showed that there was a 56% reduction in overall mortality. Furthermore, there was a reduction of heart attacks by 24% and a reduction of strokes by 36%. There was no difference between the control group without testosterone replacement and the partial testosterone replacement group where the testosterone levels did not come up. It is clear from this that with proper testosterone replacement where the physician monitors testosterone levels and corrects the levels, significant reductions in strokes and heart attacks can be achieved. The explanation for these findings is simple: both, brain cells and heart cells in males, have testosterone hormone receptors that need to be stimulated for full function.

Hormone replacement in women

This topic was confusing for many years because of the insistence of the medical profession to use horse estrogen extracts from pregnant mares (Premarin) and synthetic Provera (instead of bioidentical progesterone). These artificial hormone-like substances were used in the much-discussed Women’s Health Initiative (WHI).

Dr. Rothenberg said about this study that investigators used the wrong estrogen, the wrong progesterone, the wrong route of administration of estrogen (oral estrogen causes inflammation), and the wrong women at age 63 who already had cardiovascular disease and breast cancer.

Revisiting the Women’s Health Initiative

One important aspect that was learnt by re-interpreting the WHI was that when estrogen replacement was initiated right away when menopause started, the heart attack risk went down by 34%. Estrogen and Provera together reduced the risk only by 28% (Provera being the wrong hormone). Again, the explanation for this findings is simple: women have both estrogen and progesterone receptors in heart and brain cells, which want to be stimulated with the natural hormones. When estrogen is missing, women need bioidentical replacement of what is missing with estradiol transdermal creams. When a woman is progesterone-deficient, she needs replacement with bioidentical progesterone transdermal cream or with micronized progesterone orally.

Estrogen

KEEPS study

With regard to estrogen replacement the KEEPS study has shed a new light on what is going on with hormone replacement in women.

700 women in early menopause participated in this study. Treatment consisted of 0.45 mg of Premarin (still the wrong hormone) or 50 micrograms of transdermal estradiol (the right active human estrogen). Women also received 200 mg of micronized progesterone (Prometrium, the real human progesterone) for 12 days each month. After 4 years of observation there was no case of breast cancer, uterine cancer, heart attack, transient ischemic attack, stroke, or blood clots in veins between the three groups. Both Premarin and transdermal estrogen had slightly reduced coronary artery calcifications on CT scans compared to the placebo group without hormones. The Premarin group increased the triglyceride and the CRP (a measure of inflammation) levels while the transdermal human estrogen did not do that.

It is a disadvantage to the woman, if she does not receive bioidentical hormone replacement after menopause 

Another study showed that due to the WHI study with the wrong synthetic hormones many women were fearful of starting estrogen replacement. The lack of hormone replacement with nature-identical hormones is responsible for the death of many women, who did not have the beneficial effects. They died of cancer and heart disease.

Dr. Rothenberg explained that this study and others have shown the following
  1. Bioidentical hormone replacement must be started immediately at or before menopause to have the best results in terms of cardiovascular and neuroprotective (Alzheimer’s) prevention.
  2. Oral estrogen induces inflammation, which causes heart attacks, strokes and venous thromboembolism (blood clots). To prevent this, estradiol must be given as a transdermal cream. This will avoid the first pass effect through the liver, which is the cause for inflammation. Transdermal estradiol does not have the first pass effect. Inflammatory cytokines are implicated in autoimmune processes, initiation of cardiovascular disease, osteoporosis and Alzheimer’s disease.
  3. If estrogen replacement is not done right away with the start of menopause, the estrogen receptor may get damaged, which means that when estrogen replacement is started at a later date, it is no longer effective.

Progesterone

Progesterone is the other female hormone that physicians often overlook. It balances the effects of estrogens, but the body can also metabolize it into estrogen or testosterone. Tiny amounts of testosterone are necessary for normal libido. In premenopause the ovaries already reduced progesterone production. She should receive progesterone replacement by transdermal bioidentical progesterone cream in premenopause.

Estrogen dominance needs to be treated with transdermal progesterone (or micronized oral progesterone). Both estrogen and progesterone can be accurately determined using a saliva hormone test. Blood tests are accurate for estrogen levels, but not for progesterone levels.

Thyroid replacement

Not infrequently thyroid tests are low (hypothyroidism) and cholesterol levels rise. This can lead to heart attacks and strokes. For instance, a slightly elevated TSH of 5.5 is associated with a total cholesterol level of 209 mg/dL, and a TSH level of 7.0 is associated with a cholesterol level of 270 mg/dL (normal less than 180 mg/dL). It is very important to detect hypothyroidism early and to treat it effectively to prevent cardiovascular disease. The active thyroid hormone is T3. Thyroid replacement has a stabilizing effect on the heart rhythm. It works together with testosterone in men and estrogen in women to stabilize metabolism of all cells, but in particular the heart muscle cells and brain cells. Hypothyroid patients are often depressed, but thyroid replacement lifts the depression. Cognitive deficits in patients with hypothyroidism are also remedied with thyroid treatment.

Growth hormone replacement

Growth hormone (GH) is important in childhood for bone growth and growth of all the organs. But GH still has an important function later in life. GH improves cardiac performance; it does so by thickening the wall of the left heart chamber, the main pump of the heart muscle. GH improves the contractility of the heart muscle, reduces the stress on the heart muscle wall and decreases vascular resistance. In animal experiments GH plays an important role in remodeling the heart after a heart attack.

GH deficiency occurs with aging; it leads to high LDL (bad) cholesterol and high triglycerides in the blood and increased fibrinogen, which causes blood clots. All of this increases the risk for heart attacks and strokes.

Age-related GH production declining

When people age, they lose GH production, which puts them at a considerable risk to get heart attacks and strokes, but they are also at a higher risk of serious falls due to muscle weakness and balance problems. When the doctor detects low IGF-1 levels in the blood and confirms low GH metabolites in a 24-hour urine sample, the time has come to do daily GH injections with human GH. You achieve this using a similar pen that is in use for insulin injections. The dosage is only between 0.1 mg and 0.3 mg per day before bedtime. This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness, lack of mental clarity and general well being. Patients report that their joint and muscle aches disappear and they can engage in physical activities again.

Melatonin replacement

Most people think of melatonin as the “sleeping hormone”. The pineal gland releases melatonin. It rules overnight giving you a refreshing sleep. In the morning and during the day the light that enters your eyes inactivates it.

Melatonin is a powerful antioxidant, stabilizes the heart’s rhythm (anti-arrhythmic activity), is anti-inflammatory, anti-hypertensive and protects against heart attacks and strokes. People who have heart disease often have very low blood melatonin levels. Physicians can use melatonin intravenously in patients who have heart attacks. This will reduce the amount of damage to the tissue and stabilize the heart rhythm.

Age-related decline of melatonin production

Like with GH, the production of melatonin deteriorates significantly beyond the age of 40. Blood levels of melatonin can be easily ordered, and replacement is easy to do. 3 mg of melatonin taken at bedtime will be a sufficient dose for most people. You can take another 3 mg, if you wake up in the middle of the night. It will wear off within 3 to 4 hours.

Vitamin D replacement

The history of vitamin D3 is interesting. Vitamin D3, the active form of vitamin D has many actions: it stimulates the immune system and reduces the risk of infection, it reduces blood pressure, it reduces inflammation by reducing circulating cytokines, and it increases insulin sensitivity making insulin receptors more responsive.

Vitamin D3 binds to the vitamin D receptor, which is contained on all cells.

Many middle-aged and older people are deficient for vitamin D.  A lack of it leads to higher mortality. Vitamin D helps to restore circulation in patients with ischemic heart disease. Vitamin D insufficiency causes high blood pressure, diabetes and metabolic syndrome. In addition, vitamin D deficiency also causes enlargement and thickening of the wall of your heart’s main pumping chamber, heart failure and chronic vascular inflammation.

More on the effect of vitamin D3 preventing mortality

A prospective 7.3-year study looked at the hazard ratios of the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files with lower 25-hydroxyvitamin D levels. There were 33,994 persons part of the survey, of whom 1,493 died.

Below 10 ng/ml of 25-hydroxyvitamin D level the mortality was 2.5 fold for all causes and 3.08-fold for cardiovascular causes compared to those with levels of 100 ng/ml or higher.

The recommendation presently is to maintain serum levels at 60-80 ng/ml of 25-hydroxyvitamin D to prevent cardiovascular disease.

Effects Of Hormones On The Heart

Effects Of Hormones On The Heart

Conclusion

The following is important to remember regarding prevention of heart disease.

  1. Never smoke or if you do, quit smoking.
  2. Have your thyroid hormones checked. Thyroid hormones are important as an energy source for your heart muscle, and they lower LDL cholesterol levels.
  3. Your sex hormones matter: in men it is testosterone, in women estrogen and progesterone that support your heart.

Other effects on the heart

  1. Vitamin D is not only important when we grow bones as youngsters, but it continues to be important when we are older. It supports our heart and other body functions. It is an essential team player, as it prevents premature deaths. Blood levels of vitamin D are easy to measure.
  2. Two hormones leave us rapidly as we age: melatonin and human growth hormone. However, the physician can measure the levels of both hormones and if low he can replace what is missing.
  3. There are only two more things you need to do: eat a Mediterranean type diet and exercise on a regular basis. This will ensure your heart is still healthy in years to come.

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Jan
16
2016

Low Thyroid (Hypothyroidism)

By | Hormones, Insomnia, Obesity, Pain

Dr. Pamela Smith gave a detailed talk regarding low thyroid (hypothyroidism) at the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas. As a lack of thyroid hormones is one of the causes of premature aging, it is important to pay attention to your thyroid hormones. Here I am summarizing the highlights of this talk.

Thyroid disease, particularly low thyroid hormone levels (hypothyroidism) is very common in the population. Part of the problem is that in 72% of the world population dietary iodine is insufficient to provide adequate amounts of iodine to the body that is required for thyroid hormone production in the thyroid gland. The US Institute of Medicine has recommended 150 micrograms of iodine intake every day. Japan with its emphasis on seaweed intake, which provides iodine supplementation is one of the few countries where thyroid deficiency is extremely low (Ref.1).

But apart from dietary factors there are many other factors that can lead to insufficient amounts of circulating thyroid hormones (see below).

The production of thyroid hormones

The thyroid gland produces the thyroid hormones by adding iodine atoms into the amino acid L-tyrosine to make thyroxin (T4) and triiodothyronine (T3). T3 is the main active hormone, which is about 5-times more powerful than T4. There is a feedback cycle between thyroid hormones, the hypothalamus and the pituitary gland. Both the hypothalamus and the pituitary gland have thyroid hormone receptors that sense the level of T3 and T4 and can modify the production of these hormones. The majority of T3, which is the main active thyroid hormone, comes from conversion of T4 into T3 by a selenium-dependent enzyme.

Most of the thyroid hormones are bound in the blood by thyroid binding globulin. Only the free T3 and free T4 are metabolically active and will affect the metabolism of our body cells. The delicate balance can be easily disrupted. Oral contraceptives and sex hormone replacement therapy can increase the amount of circulating thyroid binding globulin, thus creating a thyroid hormone deficiency state, as the free T3 and free T4 are diminished.

Other factors influencing circulating thyroid hormones

Low adrenal gland hormone activity

Low adrenal gland hormone activity can occur simultaneously with hypothyroidism. On the other hand, when thyroid hormones are low by themselves, the adrenal glands often compensate by producing more cortisol to offset some of the symptoms of hypothyroidism.

Conversion of T4 to T3

An enzyme located in the liver, kidneys, pituitary gland, hypothalamus and brown fat is necessary for conversion of T4 to T3, the more active thyroid hormone. Anything that interferes with this conversion leads to hypothyroidism. Over the years medical research has identified many factors that interfere with this process. For instance, there are trace elements necessary for this enzymatic reaction, like selenium and zinc; if they are low in the diet, low T3 will be the result. But other nutrients, if missing, will also interfere with T4 to T3 conversion: iodine, iron as well as vitamins A, B2, B6 and B12.

Medication can interfere with conversion of T4 to T3

Several medications can also interfere with the conversion of T4 to T3: we already mentioned birth control pills; others are estrogen, lithium (patients with bipolar disorder are often on this), phenytoin, theophylline, beta blockers (such as propranolol), chemotherapy and clomipramine.

Too much fiber in diet can interfere with conversion of T4 to T3

But dietary factors can also lower T3 due to a lack of conversion from T4: too many cruciferous vegetables, a low carbohydrate diet, low fat diet, low protein diet, excessive alcohol use, walnuts and soy. In a study that examined the effects of soy involving 37 adults on a high soy diet over three months 50% developed hypothyroidism. When the soy diet was stopped it took one month to normalize the thyroid function (Ref. 2).

Chronic inflammation, diabetes, aging and more can lower T3

There is no end of factors that cause low T3 because of the inability to convert from T4: chronic inflammation due to cytokines, diabetes, aging, poisoning with heavy metals like mercury, lead and cadmium (cigarette smoking), fluoride, pesticides, exposure to radiation and stress. Other toxic substances that enter the body can interfere with the same T4 to T3 conversion process: dioxins, phthalates (chemicals added to plastics) and PCB. But excess calcium and copper (copper salts could come from spraying of organic fruit) can also lead to low T3.

Too much cortisol from stress can lower T3

Other hormones can disbalance the equilibrium and cause low T3 because of a lack of conversion from T4. One reason can be too much stress, which causes cortisol from the adrenal glands to rise. Surgeries cause the same stress response (high cortisol levels) also will lower T3.

Reverse T3, an inactive form of T3

There is another conversion process that has been shown to lead to lowered T3: it is called “reverse T3 (rT3)”. rT3 is an inactive form of T3, which blocks thyroid receptors and renders T3 less active. rT3 is particularly important in stressful situations and in athletes who engage in extreme exercise. In these individuals T3 and T4 blood tests are normal, TSH is suppressed and rT3 is elevated. That’s how the doctor can diagnose this condition. Other conditions that lead to high reverse T3 are: aging, diabetes, exposure to free radicals (chemotherapy or radiation in cancer treatment), fasting, prolonged illness, toxic metal exposure, inflammatory cytokines, depression and anxiety, bipolar disorder, Alzheimer’s and Parkinson’s disease, chronic fatigue syndrome and fibromyalgia.

Certain supplements and dietary habits can help to increase the conversion from T4 to T3

After all this negative news it is almost a wonder that the thyroid is still doing its work! Since we know the risk factors, it is important to be aware that certain supplements and dietary habits can help to increase the conversion from T4 to T3. Here is a list of those that help: iodine, iron, zinc, selenium, potassium, Ashwaganda, and a high protein diet. Other positive factors are vitamins A, B2 and E; growth hormone, testosterone, insulin, glucagon, melatonin and estrogen (high dose).

Symptoms of hypothyroidism

There was an overwhelming amount of information about signs and symptoms of hypothyroidism that was reviewed. I can only highlight some of the more common symptoms here. It is important to know that some of these signs and symptoms occur several years before the lab values become abnormal. This is particularly true of the “eye brow sign” and the thinning of eyebrows is a pointer to hypothyroidism!

More signs and symptoms of hypothyroidism

Depression, weight gain, constipation and migraine type headaches can be early non-specific signs of hypothyroidism. Women often present with irregular periods. Other symptoms are: decreased memory and inability to concentrate, anxiety/panic attacks, muscle and joint pains, a puffy face, swollen eyelids, decreased sexual interest, and sleep disturbance. Sparse, coarse, dry hair; missing hair confined to the outside 1/3 of both eye brows (eye brow sign) and carpal tunnel syndrome are also associated with a lack of thyroid function. Often there is also a loss of eyelashes or eyelashes that are not as thick. Blood tests can show high cholesterol, iron deficiency anemia or vitamin B12 deficiency. This should prompt the physician to order thyroid tests.

Blood tests for hypothyroidism

The doctor needs to order TSH, free T3, free T4, reverse T3 and thyroid antibodies to have a complete documentation of what is going on. In addition the doctor will order these three thyroid antibodies: antithyroglobulin antibody, antimicrosomal antibody and antithyroperoxidase (anti-TPO) antibody. There are a number of more studies that an endocrinologist would order in difficult to diagnose cases. Thyroid antibodies are an important cause of hypothyroidism in the US. They can also be due to Hashimoto’s thyroiditis, an inflammatory condition of the thyroid gland. Some people have autoimmune antibodies against adrenal gland tissue. There are also patients who have gluten sensitivity. They may produce these autoantibodies to both the adrenal glands as well as the thyroid gland.

Treatment of hypothyroidism

Treatment for hypothyroidism consists of detoxification, proper nutrition and thyroid hormone replacement.

Detoxification can include intravenous chelation therapy, if heavy metals are part of the development of hypothyroidism. In some cases detoxification is all that is necessary.

Proper nutrition with a Mediterranean diet and some iodine supplements or seaweed is important. By the time the physician diagnoses hypothyroidism, there is  damage  in the thyroid gland and the missing thyroid gland hormones have to be replaced.

Replacement of thyroid hormones

Replacement of thyroid hormones is best done by desiccated thyroid or compounded thyroid (both T3 and T4). The physician takes the normalization of the TSH level as the end point. It should be below 2.0 (not the lab normal value of below 5). Free T3 should be optimally between 3.5 and 4.3 and reverse T3 should be 50 to 150 pg/ml to be optimal.

If reverse T3 is high, the patient will have hypothyroid symptoms, even if T3 and T4 blood tests are normal. Because reverse T3 derives from T4, the physician will have to lower T4 or take the patient off T4. Replacement with T3 will lead to lower TSH production by the pituitary gland. At the same time production of T4 and inappropriate conversion to reverse T3 will decrease.

Treating concomitant factors

Depending on what other conditions the patient presents with, it likely will help to eliminate stress, treat selenium and iodine deficiency, treat infections and treat growth hormone deficiency, if present.

There were many more pearls of wisdom in this very comprehensive talk on hypothyroidism, but there is not enough room in this blog to mention all of this. For more info read Dr. Pamela Smith’s book (Ref.3).

Low Thyroid (Hypothyroidism)

Low Thyroid (Hypothyroidism)

Conclusion

The maintenance of our health and well being involves the thyroid as one of the main players. Hypothyroidism can develop for multiple reasons: inadequate iodine intake, toxins including heavy metals, autoantibodies from gluten. In addition there may be another sensitivity and side effects from certain medication usage. It is a fallacy to think that supplements, vitamins and lifestyle choices can “cure” thyroid deficiency. Once the levels are low, thyroid replacement is the only way to reestablish a hormonal balance! The treating physician must consider many factors when replacing thyroid hormones optimally. Desiccated thyroid hormone replacement (containing T3 and T4) is the best type of replacement of missing thyroid hormones. The needs can differ a great deal, as no patient is the same! For best results the treating physician needs to individualize treatment.

References

Ref. 1: Brownstein, D., “Iodine: Why You Need It, Why You Can’t Live Without It”. Medical Alternatives Press, 2004.

Ref. 2: Kelly, G., “Peripheral metabolism of thyroid hormones: A review,” Alt Med Rev 2000; 5(4):306-33.

Ref. 3: Smith, P. “What You Must Know About Thyroid Disorders”. Garden City Park, NY: Square One Publishers, 2016.

Feb
19
2014

Every Patient Is Unique

By | Anti-aging medicine, Heart Disease, Hormones, Mental Health, Osteoporosis, Vitamins and supplements, Women’s Diseases

Modern Western Medicine tends to see the disease of a patient as a unique entity. Conventional medicine behaves as if a disease is associated with characteristic symptoms, findings and lab test results, which are then treated in a standard fashion by treating the symptoms of the disease.

The reality though is different: The same disease can present in various patients with different symptoms.

Naturopathic physicians, integrative physicians and anti-aging physicians see patients as unique individuals with characteristic personality traits and slightly varied presentations, which may be shared in a disease entity, but differ substantially from person to person.

It is important to be aware of this uniqueness, if the caregiver wants to achieve the optimal treatment result.

Big Pharma does not like this approach as they would like you to think that the conventional medicine system is superior. A certain disease is treated a certain way, preferably with the most expensive drugs.

I thought that in this blog it would be good to shed some light on this important topic.

Menopausal women with symptoms

Let us consider an example of a 55-year old woman who has hot flashes, dry skin, a loss of hair from the outer aspect of her eyebrows, does not sleep well and has lost her sex drive. She also has put on 20 pounds in the last year despite no change in her diet.

This is how conventional medicine would handle this patient

The doctor examines the woman and does a Pap test as well. A conventional doctor would likely order standard blood tests consisting of a complete blood count, thyroid tests (T4, TSH) and FSH and LH levels. The conventional physician would find that the thyroid hormones are low with a high TSH (thyroid stimulating hormone) and would treat the woman with Synthroid (a synthetic thyroid hormone drug). The LH and FSH were found to be high indicating to the conventional physician that the woman is in menopause. He would offer the standard PREMPRO (a synthetic hormone preparation containing a mare estrogen combination with a progestin) with the warning that he will give her the lowest estrogen combination and only up to 5 years because of the negative findings of the Women’s Health Initiative.

Every Patient Is Unique

Every Patient Is Unique

Here is an example how a naturopathic or anti-aging physician’s would investigate and treat the patient

A naturopathic physician or an anti-aging physician would likely add a female saliva hormone panel to the other blood tests mentioned above and also do a T3 hormone level as part of the thyroid blood tests. The doctor will explain to the patient that she was found to be menopausal and also hypothyroid. With respect to the hypothyroidism the physician will explain that apart from thyroxin (T4) there is a second hormone, triiodothyronine (T3) that is also necessary in order to replace all of the thyroid hormones that humans have. Drug companies assume that T4 (Synthroid) will reverse automatically into whatever amount of T3 the body needs, so they have convinced most conventional doctors to prescribe T4 drugs only (like Synthroid). The problem is that as the body ages, the enzymes necessary to convert T4 into T3 do not work as well as in a younger age.This can be verified by testing T3 and T4 levels simultaneously.

The end result is that the patient who only gets T4 replaced may still have some of the symptoms like lack of energy and depression even when T4 has been replaced. Not so with the patient treated by the naturopath or the anti-aging physician who put our patient on Armour (porcine-derived thyroid hormone replacement containing both T4 and T3).

With regard to the blood tests and the saliva hormone tests the second patient was told that the blood tests confirmed menopause (high LH and FSH) and that the saliva female hormone panel showed what was going on. In this particular patient the female saliva hormone tests showed that the progesterone level was low, the testosterone level was low and estrogen was normal. Another hormone, DHEA-S (which is DHEA sulfate, the storage form of DHEA) was also on the low side. Cortisol that had also been tested was normal. The physician explained that the woman’s adrenal glands showed a slight weakness not producing enough DHEA, which is a precursor to testosterone. The low testosterone level was responsible for her lack of sex drive. Progesterone, which needs to be high enough to counterbalance estrogen, was missing, which was likely the cause of her hot flashes and the lack of energy together with the missing thyroid hormones. The physician explained that the woman needed a small amount of DHEA tablets by mouth, a full replacement of progesterone (through the use of a bioidentical hormone cream) and also a small amount of bioidentical testosterone cream to normalize her hormones.

A reassessment of the patients 2 months later showed that the first woman still had some depression and lack of energy, while the second woman felt her normal self again. Both women had regrown their eyebrows from replacing the missing thyroid hormones and have lost several pounds since the beginning of their treatments, but obviously there were quite different clinical results. The first woman was treated in a “standard conventional medicine” fashion, which will lead to breast cancer as unnecessary estrogen was given. She also will be at risk of getting cardiovascular disease as she was replaced with Progestin, a synthetic drug thought by conventional physicians to represent “progesterone”. The Women’s Health Initiative has proven that this was the outcome with PREMPRO and yet this drug is still on the market!

The second woman received an individualized and personalized holistic treatment protocol. The low progesterone from missing her ovulations after menopause was being replaced and her body very quickly responded favorably by making her feel normal again. The missing adrenal gland hormones and testosterone were replaced and this normalized her sex drive. Both, progesterone and thyroid hormones (T3 and T4) are anabolic hormones and they gave her back her energy and restored her sleep pattern. With normal hormone levels she also lost her depression symptoms.

Two men with depression

If you thought that the difference of these two clinical approaches were just coincidental, think again. The next examples are two men in their early 50’s who see their physicians because they felt depressed and had a lack of energy. Both were normal weight.

Here is the conventional medicine approach

The physician took a history, during which a lack of sex drive was also noted. He examined the patient and came to the conclusion that physically nothing was wrong with the man, but a diagnosis of depression was made. This would account for the tearfulness, sleep problems and loss of sex drive. The doctor prescribed one of the standard antidepressants (in this case sertraline, brand name Zoloft). Three weeks later the patient returned and as he was better, a repeat prescription for the antidepressant was given. After a further two months the patient was reassessed. When the symptoms were reviewed, it became apparent that a lack of sex drive was still present, if anything the patient felt the antidepressant had made this worse. Some of the depressive symptoms have improved on the conventional antidepressant. The doctor discussed that the antidepressant could be increased by one tablet per day. The doctor also discussed the option of using Viagra for the decreased sex drive and difficulty having an orgasm.

This would be the  naturopathic or anti-aging physician’s approach. Again similar to before a history was taken and a physical examination was done. The physician noted that the patient was in the age where a lack of sex drive could indicate an early andropause (the male equivalent of menopause, often difficult to spot with the first presentation). A depression questionnaire indicated that the man was moderately depressed. The patient was sent for blood tests and for saliva hormone tests (a male hormone panel). The physician stated that he would like to arrange for cognitive therapy treatment to sort out the various factors of his depression, but also help his mood by trying to start him on St. John’s wort, an herb that has been proven to be effective for mild to moderate depression. The blood work came back as normal. However, the hormone tests showed that testosterone was in the lower third of the normal range. DHEA-S, cortisol and estrogen were normal. So a few weeks later when the tests had come back the patient was called in.  The doctor explained to him that the low testosterone level would explain why his sex drive had deteriorated along with his symptoms of depression. Bioidentical testosterone cream was added to the antidepressant herbal treatment. The result was that within one month this patient’s sex drive was back to normal. Together with the cognitive therapy treatments and the herbal antidepressant the depression was also resolved. After a further three months of counseling he was able to stop the St. John’s wort. Due to the counseling sessions he felt stronger than ever before and his mood remained stable even when the counseling sessions were terminated. He continued to use the bioidentical testosterone cream regularly.

These are examples of two different approaches in two identical men in their early 50’s. It appears to me that the conventional approach did a disservice to the sick person, only treated symptoms, but did nothing to solve this patient’s real problems. The second case’s depression was treated properly and the physician luckily also did not miss the underlying early andropause with low testosterone levels. Repeat testosterone levels showed a high normal testosterone level, which was now in the upper 1/3 of the normal range.

The conventional approach missed the early testosterone deficiency, which  would cause heart disease, should the testosterone levels become even lower. Viagra certainly would not be the answer as this has a number of potentially serious side effects. The antidepressants at even higher doses would cause more erectile dysfunction, which was what he hoped to have treated.

Conclusion

People often have several conditions at the same time. It takes intuition, readiness to do testing, repeat close observation and repeat examination on the part of the physician. This needs to be coupled with good listening skills to sort out a patient. On behalf of the patient it is important to tell the physician all of your symptoms and observations. Be patient and never give up. A good patient/physician relationship will go a long way in sorting out complex medical problems. Every patient is unique. Not every symptom means the same thing in two different patients.

More information on:

1. Menopause: http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/menopause/

2. Depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

Last edited Nov. 7, 2014

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Aug
10
2013

Bioidentical Hormone Replacement

By | Alzheimer’s disease, Anti-aging medicine, Arthritis, Cancer, Diabetes, Fitness, Health, heart attack, Heart Disease, Hormones, Men's Health, Nutrition, Osteoporosis, Prevention, Stroke, Women’s Diseases

In many previous blogs I have mentioned that bioidentical hormone replacement prolongs life. Here is a more detailed look at what such hormone replacement looks like for both women and men. Before I get into details I want to stress that I am talking about replacing what is missing and replacing only with natural hormones, not some artificial hormone derivative produced by a drug company. The reason this is immensely important is that hormone receptors in the body are distributed all over our vital organs including bones, blood vessels and the nervous system. If there is no lock and key fit (bio-identical hormone fitting the hormone receptor), there is trouble as the Women’s Health Initiative in 2002 has shown. Unfortunately they had used synthetic hormones for HRT that were not fitting the hormone receptors, and this caused many problems (heart attacks, strokes, osteoporosis, cancer).

Physiology of aging

As we age, we gradually produce fewer hormones in our hormone glands, but the various hormone glands deteriorate in their functions at different rates. Beyond the age of 30 we produce less melatonin and less growth hormone. As a result our sleep pattern may change, as melatonin is necessary for a deep sleep. The decreasing growth hormone production means that we are losing some of our muscle mass and accumulate more fat in the subcutaneous tissues. Our adrenal glands produce less DHEA at the age of 35 to 40, a hormone that is a precursor to our sex hormones in males and females. The gonads (testicles and ovaries) also produce fewer hormones, a process which already starts 5 years before menopause and about 5 years before andropause (the male menopause equivalent).

Typically a woman will get into menopause at the age of 45 to 55 at which time the periods stop and postmenopausal symptoms are interfering with her well-being.  Men get into andropause (the male equivalent of menopause) at the age of 55 to 65 at which time erectile dysfunction occurs and often the individual will become the “grumpy old man”.

Other hormones such as thyroid hormones are also affected by the slow down. Hypothyroidism is common in people above the age of 50.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Baseline laboratory tests

In order to know what is going on, the physician or naturopath needs to order a number of tests to assess whether there is inflammation, how your key hormone levels are; the cardiovascular system markers should also be checked, the liver enzymes and vitamin D3 level. Inflammatory markers are fasting insulin levels and C-reactive protein (CRP). Fasting cholesterol and subfractions (HDL, LDL, VDLP, small LDL) and fasting triglycerides are also measured. Thyroid hormones (T3 and T4, TSH) are measured to rule out over or under function. Typically hypothyroidism is found, which would have to be rectified by taking Armour (a mix of T3 and T4 thyroid hormones).

At this point I need to explain that long time ago the research by Dr. Lee has shown that progesterone hormone levels are notoriously unreliable when blood tests are done. All of the other sex hormones, and cortisol are also not that reliable with blood tests. For this reason the saliva hormone tests have been invented that conveniently report a panel of 5 hormones from one saliva sample: DHEAS (which is the storage form of DHEA), estradiol (the major estrogen in a woman), progesterone, testosterone and cortisol. The saliva hormone tests correlate very well with the actual tissue hormone levels. You can order the saliva tests through Dr. Lee’s website. Another longstanding lab in the US is Dr. David Zava’s lab. In Canada the Rocky Mountain Analytical Lab can process your saliva tests.

Women’s hormone replacement

Let us assume that a woman is getting postmenopausal symptoms and bioidentical hormone replacement is being discussed. The physician will want to first rule out that insulin resistance is not present by ordering a fasting insulin level. If this is normal and the other baseline tests are normal as well except for missing estrogen and progesterone, the physician will usually start to replace progesterone first using a bioidentical hormone cream to be applied once or twice per day. If estrogen levels were also low, the next step in 4 weeks or so is to add Bi-Est, a bioidentical estrogen replacement cream. After 8 weeks of hormone replacement the saliva hormone test is repeated to see whether the estrogen and progesterone levels have come up and also, whether the ratio of progesterone to estrogen is at least 200 or more. Dr. Lee has extensively researched this and found that women with a ratio of less than 200 to 1 (progesterone/estrogen ratio) were more prone to breast cancer. He also stated in this link that there are 3 basic rules with regard to bioidentical hormone replacement:

1. only replace hormones, when they were measured to be low.

2. use only bioidentical hormones (never synthetic hormones) and

3. only replace with low doses of bioidentical hormones to bring hormone levels to physiological levels (body levels that were experienced to be normal before).

Many women who are not replaced in menopause have estrogen dominance meaning that the progesterone/estrogen ratio is less than 200:1, which puts these women at risk of developing breast cancer. Women who are overweight or obese also are estrogen dominant (from estrogen produced in excess through aromatase in the fatty tissue, explained further below), which makes them more prone to breast cancer, uterine cancer and colon cancer. Without bioidentical hormone replacement inflammatory processes take place in the joints (causing arthritis), in the nervous system (causing Alzheimer’s and dementia) and in the blood vessels (causing heart attacks and strokes). Rebalancing your hormones to a youthful state by paying attention to the hormone levels and the hormone ratios mentioned will remove the inflammatory reactions and reduce the risk for cancer.

Men’s hormone replacement

Males enter andropause 10 to 15 years later than women are entering menopause. Typically testosterone production slows down leading to hair loss, erectile dysfunction, loss of muscle mass, osteoporosis and Alzheimer’s/dementia. Blood tests (bioavailable testosterone) or saliva tests are both reliable in determining a deficiency. Replacement with bioidentical hormone creams once per day is the preferred method of treatment. Overweight and obese men produce significant amounts of estrogen through an enzyme localized in fatty tissue, called aromatase.

Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Estrogen causes breast growth, weakens muscles, and leads to abdominal fat accumulation, heart disease and strokes.

Similar to women, where the progesterone/estrogen ratio is important, there is another ratio for men, called testosterone/estrogen ratio. This should be in the 20 to 40 range for a man to feel good and energetic. Unfortunately many men above the age of 55 have testosterone/estrogen ratios much smaller than 20. This makes them more prone to heart disease and prostate cancer (Ref.1).

However, a male also does need a small amount of estrogen and normal thyroid hormones as well as all of the other hormones for his “hormonal symphony” (mentioned in Ref. 2) to function at his best.

Safety of hormone replacement

There are still otherwise reputable websites that state that bioidentical hormones are not safer than standard synthetic hormones. This confuses the consumer and does not serve the public well. I much prefer the text of the Wikipedia, which is a more thorough review regarding safety of hormone replacement and explains what the issues are.

In the US there is a collective experience of about 25 years on thousands of patients, but there have not been any randomized studies, as Big Pharma that would have the money to finance such studies is not interested in proving that bioidentical drugs would be safer than their distorted synthetic hormone copies that will not fit the body’s hormone receptors. There are some noble exceptions as Big Pharma is producing bioidentical insulin and human growth hormone that had toxicity studies done and showed safety. In Europe bioidentical hormones have been used since the 1960’s, on a larger scale since the 1970’s. So the European experience of safety of bioidentical hormones is presently about 40 to 50 years.

The FDA is contributing to the confusion of the public as can be seen from this publication. One example where the FDA is confusing the consumer, is the progesterone product Prometrium, a bioidentical micronized progesterone capsule that can be taken by mouth. By law the manufacturer had to put a warning label on the package identical to progestin, which is the synthetic, non-bioidentical hormone having been shown to have severe side effects. As is explained in this last publication Prometrium should not have been required to have a warning label in it ; the paper explains what I have already stated above, namely that bioidentical hormones are the safest form of hormone replacement and administered in the right ratios will actually prevent cancer and prevent premature cardiovascular and joint deterioration. In other words, bioidentical hormone replacement can add many years of useful life when started early enough before permanent organ damage sets in from the aging process (which would be due to missing hormones).

Why bother about hormone replacement?

Nature has a plan of “knocking us off” to make room for the next generation. The only way that you can change nature’s plan of killing us prematurely through cardiovascular disease, arthritis, dementia and loss of your sexual life is by bioidentical hormone replacement. Of course you also need the other ingredients of known life prolongers such as healthy (preferably organic) foods, exercise and detoxification. Many women are scared to treat the hormone deficiencies that cause their menopausal symptoms because of the Women’s health Initiative results with synthetic hormones. Men who would benefit from testosterone are often anxious that they may get prostate cancer, when in reality it is the exact opposite: testosterone prevents prostate cancer (Ref.3).

Conclusion

I wrote this blog about bioidentical hormone replacement in order to clarify this often-misunderstood topic. Don’t get confused by the FDA, by highbrow medical websites (such as the likes I mentioned). Big Pharma has a powerful lobby that attempts to keep the medical profession in the belief that their products are better than those that nature has provided (I call it “defend your patent rights”). We are still in a flux state where anybody who tells the truth about hormones gets much criticism. In another few decades it will be an accepted fact and people will wonder why the Women’s Health Initiative was done without a control with bioidentical hormones. With bioidentical hormone replacement you can add about 20 years of youthful life without disabilities to the normal life expectancy. Exercise, detoxification and organic food with avoidance of wheat, starch and sugar can add another 5 to 10 years to your life. The baby boomers are lucky that they have this new tool to prolong life. I wonder whether they will put it to good use.

More information about bioidentical hormone replacement: http://nethealthbook.com/hormones/anti-aging-medicine-women-men/

References:

1. John R. Lee: “Hormone Balance for Men – What your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation”, © 2003 by Hormones Etc.

2. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

3. Abraham Morgentaler, MD “Testosterone for Life – Recharge your vitality, sex drive, muscle mass and overall health”, McGraw-Hill, 2008

Last edited Nov. 7, 2014

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Jan
03
2013

Thinking Of Health In The New Year

By | Anti-aging medicine, Fitness, Health, Heart Disease, High Blood Pressure, Hormones, Nutrition, Obesity, Prevention

The following article is about thinking of health in the New Year. As we start a New Year (2013) it is a good time to reflect on our health, what makes us healthy, what keeps us healthy and what makes us age less quickly.
Here are a few thoughts, partially my own, partially influenced by the 20th Anti-aging conference in Las Vegas in December of 2012.

Stay away from cigarettes

1. In particular, we know that cigarettes are no longer in. But in the casinos of Las Vegas and outside of restaurants a lot of people are still smoking! Here is a website that tells you why you should quit.  Notably, cigarettes cause lung cancer, hardening of the arteries, strokes, and often reduce life expectancy by 10 to 15 years. To emphasize, if you are smoking do anything to quit this habit! Acupuncture helps, Nicorette assists you in overcoming the addiction part of smoking. In addition, self hypnosis discs are also helpful.

Reducing toxins

2. Reduce toxins in your life: you may think that toxins consist of lead, mercury and other heavy metals and that only people in certain industries would be exposed to those. Not so. It is in the air we breathe. Your tooth fillings (silver amalgam fillings) may leech out mercury, old paints at home could still expose you to lead, as would fashion jewelry made in China. Various foods contain toxins in them in form of residues from herbicides and insecticides. How do we detoxify? Vitamin C is a good start. It can be taken as a daily vitamin supplement (see below).

Intravenous chelation therapy

Detoxification can be done intravenously, if urine and blood tests show high levels of toxins.

This is something an anti-aging doctor or a naturopathic doctor can help you with. Glutathione and vitamin C can be given intravenously for chelation treatment with the least side-effects. Here is a link that tells you more about chelation in general.

Staying away from modern wheat and genetically modified foods

3. Cut out wheat and other genetically modified foods: What’s the thing about wheat? Read my blog about this.
All of the wheat we get today in bread, cereals, pasta, pizzas etc. has been genetically modified and has about 7 times the gliadin concentration that the original wheat species had before BASF did the chemical modification of  wheat in the 1960’s and 1970’s. Today practically all of the commercial wheat is this type.
As a result I have avoided wheat in my food intake since 2001. When you avoid wheat and sugar, which is another culprit (sugar is simply too strong for your body to handle and leads to hyperinsulinism and diabetes) you will likely loose whatever weight is too much for you without any effort.

Thinking Of Health In The New Year

Thinking Of Health In The New Year

Eat mostly organic food

4. Eat only organic food , if you can afford it. Or grow your own vegetables and lettuce in your vegetable garden, if you can. Because of what I said under point 2 above, I stay away from regular vegetables and lettuce that are sold in super markets as they contain residues of round-up (herbicides) and insecticides on them. Organic food nowadays is affordable as enough of us demand it. Even Wal-Mart has some organic foods! Keep an eye on your body weight and aim for a body mass index between 21.5 and 23.0. Several long-term studies have shown that the BMI is worth observing in order to reduce mortality.

The Singapore Chinese Health Study: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0014000

The Buffalo Health Study:  http://aje.oxfordjournals.org/content/146/11/919.full.pdf+html

Regular exercise

5. Exercise regularly 5 to 7 times per week. Perhaps one of the most important points is regular exercise. Engaging in ½ hour of vigorous exercise three times per week reduces your probability of coming down with a serious illness that could kill you by 15%. If you exercise 5 to 7 days per week for 30 minutes or more this percentage goes up to about 40%. If you exercise 60 minutes 6 to 7 times per week in a gym, you reduce mortality by about 50 to 60%. Here is an interesting graph that shows that older adults benefit more from exercise than younger adults do.

Have your hormone status checked yearly

6. Have a yearly check-up including a check-up of your hormone status: As we age, our hormones reduce in a characteristic patterns with melatonin and growth hormone production going on a downhill slope after the age of 30, followed soon by DHEA and cortisol. Often by the time a woman reaches menopause at the age of 35 to 50, there is a lack of estrogens, progesterone, and often also of thyroid hormones. In a man this decline (andropause) may take longer until the age of 55 to 65 before he experiences a lack of energy, erectile dysfunction and muscle weakness from testosterone deficiency. Sex hormones are best measured in saliva samples, the remaining hormones in blood samples. Here is a website that describes the various hormones that often need replacement (note that I am not endorsing this website, just citing it as an example of what to look out for).

Bioidentical hormone replacement

  1. Replace hormones only with bioidentical hormones: When there is a hormone deficiency, a doctor would usually replace the deficiency with synthetic hormones from Big Pharma. This was good for the profits of the companies, but bad for people as the Women’s Health Initiative has shown.
    As a result of this study (showing heart attacks, strokes, breast cancer) a lot of American women and women around the world were unjustly horrified of hormone replacement.

Bioidentical hormone replacement safe

However, many trials with bioidentical hormones around the world have proven that bioidentical hormone replacement with hormone creams from compounding pharmacies add years of life expectancy as these hormones restore all body functions back to normal. No breast cancer, no heart attacks and no strokes were noted on these natural hormones. The key is to replace with low doses and slowly under the supervision of a naturopathic physician or anti-aging physician.
Here is a site that explains bioidentical hormone replacement (note that I am not endorsing this center, just citing it as an example of what to look out for).

Friendships and hobbies

8. Have hobbies, cherish friendships. Social networking is good for your emotional health. It reduces stress, re-balances your hormones, reduces your risk of heart attacks and strokes.

Cherish your spiritual life

9. Don‘t neglect your spirituality. Be part of a church community that builds you up, if you are religious. For those who no longer belong to a church group, meditate instead, use yoga, do self hypnosis or read an inspiring book. Music can energize you or contribute to relaxation.

Vitamin and mineral supplementation

10. Use vitamin and mineral supplements. There are a number of vitamins and minerals that have anti-oxidative effects. They help to detoxify your body and protect you from some of the environmental challenges. I have discussed them elsewhere in more detail under this link.

So, here they are, the 10 steps to a healthier 2013. Review what you are doing in your life . You may need to only modify the one or the other point. Otherwise, if you have identified several points you want to change, just start with the ones you feel can be achieved the easiest first and then gradually tackle the rest. Your reward is more energy and you will probably find it difficult to hide your successes from your friends.