Introduction to Hormones
Hormones can be described as the major chemical messengers in the body that affects a wide variety of functions in the body ranging from mood disorders to cancer development. Therefore, optimal health in both men and women highly depends on proper sex hormone balance. All of these hormones, and their metabolites, interact and affect each other. Understanding this concept, our doctors take a comprehensive approach to hormonal imbalances by measuring not only the major sex hormones, but also their metabolites in order to determine the exact cause of hormone imbalance.
Hormone imbalance may be associated with a variety of clinically significant disorders.
In women, hormone irregularities can cause:
· Abnormal/Painful Menstrual Cycles · Autoimmunity
· Bloating · Cancer
· Chronic Digestive Upset · Decreased Bone Strength
· Decreased Libido · Emotional Fragility
· Excessively High/Low Energy · Excessive Weight Gain/Loss
· Fibrocystic Breast Disease · Hot Flashes/Night Sweats
· Infertility · Migraine Headaches
· Mood Swings/Anxiety/Panic Attacks · Ovarian Cysts
· Painful Intercourse · PCOS
· PMS · Repeated Miscarriage
· Uterine Fibroids · And More…
In Men, hormone Irregulates can cause:
· Autoimmunity · Bloating
· Cancer · Cardiovascular Disease
· Chronic Digestive Upset · Decreased Bone Strength
· Decreased Libido · Emotional Fragility
· Erectile Dysfunction · Excessively High/Low Energy
· Excessive Weight Gain/Loss · Infertility
· Migraine Headaches · Mood Swings/Anxiety/Panic Attacks
· And More…
The Balanced Body Approach to Hormone Imbalance:
Here at The Balanced Body Center, our doctors understand it is important when regulating hormones to look at the complete biochemical pathway of hormone production and elimination. Simply replacing a hormone, such as giving testosterone for testosterone deficient men, without understanding why the hormone level is low can have many negative effects.
In the example of low testosterone in males, testosterone may be low due to an over conversion of testosterone to estrogen (a common testosterone pathway). Therefore, increasing testosterone levels via prescribed testosterone may temporarily decrease symptoms, while further increasing estrogen levels in the long run, making a bad situation worse.
Similarly, in an estrogen dominant woman, total estrogen levels may be within normal limits, yet the pathway in which estrogen is broken down may result in estrogen dominant symptoms. The effectiveness of hormone elimination through detoxification pathways is also an important factor in hormone balance as a decrease in hormone detoxification can lead to hormone imbalances as well. For these reasons, and many others, it is important to take a comprehensive, natural approach to support the body’s own ability to regulate hormones rather than simply replacing with synthetic hormone medications.
Blood Chemistry Studies with Orthomolecular Evaluation:
Since many organs and systems affect hormone balance (especially liver and gastrointestinal function), it is essential to start with complete blood chemistry tests. Our standard chemistries allow our doctors to evaluate the body’s major systems. By using an advanced form of interpretation called Orthomolecular Medicine, our doctors can discover hidden nutritional deficiencies, early organic dysfunction and the cause of many imbalances. Once the tests are evaluated, a treatment plan is established.
Neurotransmitters and Hormones
Hormones are often interdependent with neurotransmitters which are an important aspect in dealing with hormone imbalance. Neurotransmitters are the chemical messengers in the brain that play a major role in regulating several body systems, including hormone production. When neurotransmitters become imbalanced, it forces hormones to work harder to compensate during a stress response, potentially altering hormone balance. Therefore, it is important to take neurotransmitters into consideration any time hormone problems are suspected. Our office uses neurotransmitter, adrenal, and hormone testing to determine if you are not generating enough neurotransmitters/hormones, not converting one to another, or if you are not eliminating old neurotransmitters/hormones appropriately. We then can supply your body with what it needs to regulate balance and overall health.
Intestinal Dysbiosis
Intestinal dysbiosis is an imbalance of bacterial colonization within the gastrointestinal tract. With roughly 100 trillion bacterial organisms living in the gut at any given time, each with their own effects on the human body, it is important to ensure that the right types of bacteria are predominately present to ensure optimal overall health. There are many ways in which dysbiosis can have a negative effect on hormone balance, one of which is the alteration in neurotransmitter production. Neurotransmitters are chemicals used by the nervous system to carry out functions. Bad bacteria will prevent the neurotransmitter dopamine from converting to another neurotransmitter, norepinephrine. This results in a drop in norepinephrine that can lead to an increased production of cortisol in response to stress. Over production of cortisol can lead to a depletion in many other hormones as the body shifts it focus on producing cortisol over other hormones.
Intestinal Dysbiosis also can also cause a condition termed “leaky gut” in which molecules that would normally not get absorbed into the blood stream are absorbed. This causes an inflammatory response that negatively affects many systems in the body (including hormones) thus potentially resulting in hormone imbalance. Our office utilizes organic acid testing in order to assess the bacterial environment in the gut and determine the proper treatment to re-establish proper functioning of the body’s regulatory systems.
Environmental and Metal Toxicity Testing
It is important to consider endocrine disrupting toxins in the body when evaluating and treating hormone imbalances. Our office utilizes heavy metal and environmental toxicity testing in order to evaluate potential hormone disruptors in the body. Once toxic elements are identified, our office uses various natural products to help bind and eliminate these toxins naturally and effectively.
Methylation and Genomics Testing
Genes can be described as the blue prints of the human body. Genes dictate how our body builds structures, including hormones and neurotransmitters. Sometimes within the genetic code, a methylation defect can exist meaning that certain enzymes (proteins that carry out function) are not designed to work as fast as the body needs. These enzymes are responsible for methylation, which is a chemical process of attaching a chemical (methyl group) to an enzyme in order to activate it. This is an essential process in hormone balance as enzymes are required to make, break down and eliminate hormones. And yet, many people are only able to carry out a percentage of this process due to genetic weakness. Even though we cannot change your genetics, our office has supplements that are methylated (already activated) in order to give your body the products it needs to carry out its processes at 100% capacity.
Understanding Hormones: A General Overview
CORTISOL
Cortisol is the major stress (fight or flight) hormone released from the adrenals and plays major role in sleep/wake cycle, metabolism, sugar regulation as well as regulating the sex hormones. The typical effect of excess cortisol is usually stimulatory (effects sleep) and catabolic (breaks down muscle and tissues). The typical effect of a deficiency of cortisol results in fatigue and difficulty in waking. When cortisol is elevated long term, other sex hormones can be diverted to cortisol production (pregnenolone steal), thus resulting in hormone imbalance due to decreased sex hormone production. If this continues, the body may not be able to keep up with production demands, and cortisol, as well as other sex hormones, can deplete resulting in severe fatigue (adrenal fatigue/insufficiency).
PROGESTERONE
Most progesterone in females is created in the ovaries, hence the removal or shutting down (whether by natural or chemical means) of the ovaries causes a significant reduction in progesterone. Lifestyle and health factors can further decrease progesterone levels. Measuring progesterone is important to evaluate in hormone imbalances as progesterone plays a critical role in menstruation and reproduction, works as an antagonist to estrogen, is anti-inflammatory, regulates immune function, affects brain function, is neuroprotective, affects myelination (protective coating of nerve cells), reduces spasm, relaxes smooth muscle (found in arteries and organs) and much more.
DHEA
DHEA is the precursor of androstenedione, testosterone and the estrogens which, when measured, can give clues as to why hormone balance is disrupted. Depressed DHEA output can result in a decrease in the sex hormones derived from DHEA or indicate an over conversion of DHEA into the subsequent hormones. Conversely, elevated levels can indicate decrease in hormone conversion or over production of sex hormones. DHEA is particularly important in post-menopausal women as almost all testosterone and estrogen are derived from adrenal production of DHEA.
TESTOSTERONE
Testosterone is a steroid hormone that is produced in the testes and to a lesser extent in the adrenal glands. In both men and women, testosterone plays a key role in health and well-being as well as in sexual functioning. Examples include enhanced libido, increased energy, increased lean muscle mass, increased production of red blood cells and protection against osteoporosis. Excessive levels of testosterone have been associated with high cholesterol, prostate problems, atherosclerosis and aggression. Low testosterone can be a result of decreased production; however, low testosterone can also be a result of an over conversion issue as testosterone is converted to estradiol (E2) or dihydrotestosterone (DHT).
There are many factors that can contribute to an over conversion of testosterone to estrogen, potentially leading to lack of motivation and erectile dysfunction. There are also many factors that can contribute to the over conversion of testosterone to DHT, which is a major contributor to prostate growth and cancer. This is why it is often harmful to increase testosterone levels through hormone replacement therapy despite having a decreased testosterone and why our doctors take a comprehensive, natural approach to hormone imbalance.
THE ESTROGENS
ESTRONE (E1)
Estrone is synthesized from androstenedione, a derivative of progesterone, and is the least abundant of the three estrogens. Estrone is important to health and disease states because of its conversion to estrone sulfate, a long-lived derivative. Estrone sulfate is important in estrogen balance as it acts as a reservoir that can be converted, when needed, to the more active form of estrogen, estradiol. Estrone is the only estrogen that is present in any quantity in postmenopausal women.
ESTRADIOL (E2)
Estradiol is present primarily in the reproductive years and supports the lining of the vagina, the cervical glands, the endometrial lining and the lining of the fallopian tubes. Estrodiol has a profound effect on bone health as estrodiol deficient women have been found to experience an accelerated loss of bone mass. E2 also has an effect on the liver and imbalances can lead to gallbladder dysfunction. The production of proteins responsible for blood clotting rely on E2 (which is why in part oral contraceptives increase risk of blood clots).
ESTRIOL (E3)
Estriol is primarily released from the placenta in pregnancy but is also produced via conversion of estrone and estradiol in the liver non-pregnant women. Measurement of estriol is important in determining if estrogen dominance or deficiency is due to an over conversion, under conversion or elimination issue in estrogen imbalance.
2-HYDROXYESTRONE/16α-HYDROXYESTRONE Ratio
Research has shown that it is not simply the amount of estrogen circulating in a woman’s body that is critical to her health. The way estrogen is broken down, metabolized and eliminated in the body also plays an important role in the development of a wide variety of estrogen driven conditions—such as autoimmune disorders, osteoporosis and certain cancers.
There are two competing pathways representing a "fork in the road" in estrogen metabolism. The dominant pathway results in estrogen breaking down into the inactive 2-hydroxyestrone, a possibly anti-estrogenic metabolite. 2-hydroxyestrone is sometimes referred to as the "good estrogen” since it is not likely to stimulate increased cell multiplication in certain tissues (breast or endometrium) which can increase DNA damage and tumor growth. In addition, 2-Hydroxyestrone latches onto estrogen cell receptors and thus blocks the action of more potent estrogen metabolites from affecting cellular growth.
Through an alternate chemical pathway, estrogen can be broken down into 16α-hydroxyestrone (the “bad estrogen”). This metabolite is much more active and has a powerful stimulatory effect on cell multiplication, increasing the risk of DNA damage and tumor growth. Because of this, higher levels of 16α-hydroxyestrone may increase the risk of estrogen-dependent conditions, such as lupus and breast cancer.
The levels of 2-Hydroxyestrone and 16α-Hydroxyestrone, along with the balance between these metabolites (their ratio) provides important information about proper estrogen balance. For instance, the total levels of estrogen may be normal, but the 2-hydroxyestrone/16α-hydroxyestrone ratio can be low, indicating dominance of the “bad estrogen.” This can cause symptoms of, or an increased risk of, conditions linked to estrogen dominance. Inversely, if the 2-hydroxyestrone/16α-hydroxyestrone ratio is high, indicating dominance of “good estrogen,” there may be a lack of stimulatory estrogen required to maintain bone mineral density (increases risk of osteoporosis). The ultimate goal is to restore proper balance to improve overall health and prevent future estrogen fed conditions through a variety of lifestyle, dietary, and individualized supplement strategies.
Summary
Our office offers a complete approach to hormone imbalances that includes the most modern diagnostics and a holistic treatment plan. Hormones are an important part of overall health and great detail should be utilized in supporting the body’s own ability to establish proper hormone balance.