HORMONES 911

Your hormones should exist in harmony with each other, BUT when balance is lost, hormone deficiencies and excesses can cause chronic symptoms and disorders such as: Fatigue, Headaches, Weight Gain, Irritability, Infertility, Mood swings, Loss of libido (sex drive), and Depression.

Bioidentical hormones were brought into the spotlight after women sought a safe alternative for synthetic hormone replacement therapy. The difference between bioidentical and synthetic hormones starts at the molecular level.

Synthetic hormones, on the other hand, have an altered molecular structure that the body does not recognize completely, thus their actions are not straightforward and they are not detoxified from the body as easily. Side effects are common with these types of hormones because they are foreign to the body.

Synthetic hormones are prescribed as a “one size fits all", and cannot be specifically made for an individual.

The individualized approach of bioidentical hormone treatment requires a saliva hormone test. This will measure only active (free/unbound) hormone levels unlike serum tests, which reflect inactive (total/bound) levels. Measuring inactive hormone levels is not useful in assessing function or balance. When testing the sex hormones through saliva, it is also important to assess adrenal status (DHEA and diurnal cortisols). Even if the chief complaints seem to be an imbalance of the sex hormones, the adrenal and sex hormone pathways are so closely linked that an imbalance in one area will affect the function and efficiency of the other.

Transdermal Delivery System

The state of the art delivery system for bioidentical hormones is transdermal. By applying hormone to the skin rather than ingesting it, the liver first-pass is averted, thus therapeutic levels can be reached with far less hormone. Studies have shown that measurement of transdermal hormones is best done through saliva rather than serum. Overdosing of hormone supplementation is often seen when using serum to monitor topical hormones (often 4-5 times higher than is needed).

Where to Start

A good starting place for assessing hormonal status is to measure estradiol, progesterone, testosterone, DHEA, and am/pm cortisol. Remember: cortisol has a well established 24-hour diurnal rhythm, and the time of day when this is measured will reveal unique aspects of one’s health. If there are complaints of sleep disruptions, a night cortisol should also be performed, and if there are suspected metabolic and blood sugar dysregulations, all cortisols should be tested (morning, noon, evening and night)

Books/Articles to Read

Female Hormones:

• What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Hormone Balance
  by John R. Lee MD and Virginia Hopkins

• What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life from Thirty to Fifty
  by John R, Lee MD, Jesse Hanley, and Virginia Hopkins

• Natural Progesterone: The Multiple Roles of a Remarkable Hormone
  by John R. Lee MD

References for the above information:

Bibliography