Bio-Identical Hormone Replacement Therapy

     The hormones cascades of the human body represent a delicate and intricate dance of physiological processes. Hormones undergo enzymatic processes that change the hormone from one hormone to another based on the needs of the body. Hormones cannot arbitrarily change from one to another. Specific hormones follow a specific cascade. As an example, estradiol cannot become a thyroid hormone like thyroxine. Below you will find a brief description of some of the hormones of the adrenal glands, ovaries, testes, pineal gland, thyroid and pancreas. Evaluation and management with an experienced health care provider is recommended to navigate the complexities of this fascinating system.

  • Pregnenolone: Pregnenolone is a naturally occurring precursor hormone derived from cholesterol in the human body. When we say precursor what we mean is that this hormone undergoes enzymatic processes based on the need of the body to become more specific hormones. Pregnenolone really is the building block of the steroid hormones. Through enzymatic processes this hormone becomes progesterone, DHEA, and eventually estrogens, testosterone, cortisol and cortisone. Additionally, supplemental pregnenolone has been shown to have putative memory-enhancing activity.

  • Dehydroepiandrosterone (DHEA): DHEA is a natural substance produced in the adrenal glands, gonads, and in the brain. It is a steroid prohormone and a precursor for both androgens (androstenediol, androstenedione, and testosterone) and estrogens (estrone and estradiol). DHEA and DHEAS (Dehydroepiandrosterone-3-sulfate) have been shown to exhibit anti-inflammatory, anticancer, antiobesity, antidiabetogenic, immunomodulating, memory-enhancing, and antiaging actions.

  • Progesterone: Progesterone is one of the two main hormones, the other being estrogen, made primarily in the ovaries of menstruating women. Progesterone is made in smaller amounts by the adrenal glands in both sexes and by the testes in males, being an important step in the biosynthesis (production) of adrenal cortical hormones and by the central nervous system. It has three major functions (1) the survival and development of the embryo, (2) a broad range of intrinsic biological properties, and (3) its role as a precursor of other steroid hormones. Progesterone is essential for females and males in order to balance levels of estrogen, maintain production of cortisol, and assist the body with a multitude of physical and biological processes.

  • Testosterone: This hormone contributes to energy, muscle mass, strength, endurance, decreased fat, increased exercise tolerance, enhancement of well-being, and psychological status. Testosterone protects against cardiovascular disease, hypertension, obesity and arthritis. It leads to improved lean muscle mass, increased libido, and sexual performance. The majority of testosterone is produced in the male testes and in the female ovaries but both sexes produce the hormone in the adrenal glands as well. Testosterone levels can dramatically decline after the age of forty in both men and women. A common symptom of declining testosterone in the male (Testosterone deficiency syndrome) is fatigue. A common symptom of low testosterone in females may be low libido. Testosterone is extremely important in the male as well as the female.

  • Melatonin: Known to many as the “sleep hormone.” Melatonin is the principal hormone of the pineal gland. It is involved in setting the timing of the circadian rhythm (our “body clock”) that tells us when to sleep, wake, eat, etc. as well as our response to changes in day length in relationship to the change of seasons. Supplemental melatonin may be indicated for persons with some forms of insomnia or other sleep disturbances. Improved sleep patterns serve to energize the body and improve mood.

  • Thyroid hormones: The thyroid is a key member of the endocrine system. The two principle circulating hormones of the thyroid gland are thyroxine and triiodothyronine. A deficiency of these hormones may cause a person to exhibit signs of hypothyroidism such as: fatigue, weight gain, thinning hair, and cold intolerance as examples. Excessive thyroid hormone may cause a patient to exhibit signs of hyperthyroidism such as: rapid weight loss, heat intolerance, low exercise tolerance, and increased nervousness. Balance of the thyroid hormones are essential for maintaining health and wellness. Dysfunctional thyroid activity can cause a disruption of multiple body systems.

  • The estrogens: The “female hormone,” is responsible for secondary sex characteristics, viability of vaginal tissue, soft skin, and bone health in the female. Although many people consider this hormone female in nature the truth is that men also produce this hormone. The majority of the hormone, or hormones, are produced in the ovaries of females and in the testes of males. Like the other sex hormones, the estrogens are also produced by the adrenal glands and can be produced peripherally. Estrogen balance is important for females as over or underproduction can cause a myriad of symptoms such as: irritability, hot flashes, night sweats, weight gain, and tender breast tissue as examples. The role of estrogen balance in males at a physiologic level is still being investigated but it is known that estrogen plays a role in male fertility. What is known is that the overproduction of estrogen in the male patient can cause many of the same symptoms described for the females.

  • Cortisol: This hormone is produced in thecortex of the adrenal gland. It is a member of the steroid hormones known as the glucocorticoids. It is instrumental in helping the body achieve the proper balance of glucose (sugar). Cortisol also has anti-inflammatory effects, and promotes peripheral utilization of lipids. Cortisol is the hormone that gets us ready for the day. It begins to rise before we wake in the morning and steadily declines throughout the day to its lowest point before we go to bed. Increases in stress can cause cortisol levels to rise in order to prepare our bodies for the stressors. Unfortunately, the frequent rise and fall of cortisol from daily stressors can take a toll on adrenal glands and instead of a typical pattern of cortisol release we may experience symptoms of high or low cortisol. Symptoms of a disruption of cortisol balance may include: fatigue, foggy thinking, wired in the morning and tired all day, wired in the evening and difficulty sleeping, insomnia, early waking, sugar or salt craving, mood disturbances.

     

  • Insulin: This hormone is secreted by the pancreas in response to rises in blood sugar. In order for normal physiological processes to continue there must be a balance between blood sugar and insulin. Persistently high levels of blood sugar require the pancreas to produce more insulin to maintain balance. Persistently elevated levels of insulin may cause the patient to have increased weight, predispose the patient to multiple serious health conditions. Increased weight gain, elevated blood pressure, pre-diabetes, insulin resistance, and abnormal levels of cholesterol are all examples. The patient with insulin imbalance is at a greater risk for developing diabetes, heart disease, and stroke.