WHAT HORMONES ARE AND HOW THEY WORK
The word hormone comes from the Greek word meaning to excite. And hormones certainly do excite. While the physical changes of adolescence to adulthood, the male sex drive, and the hot flushes and mood swings of menopause are what come to mind when we talk about hormones, their tremendous power and range go far beyond what we see them as. They are responsible for the amazing growth spurt from birth through adolescence, for the roller-coaster years of puberty, for sexual desire and reproduction, and for day-to-day energy production and metabolism.
In Australia, it is illegal if medications are obtained from the black-market. It is not illegal if obtained from a doctor for genuine health and well being reasons. Extensive continuing medical tests are performed before, during and after treatment, which include physical, biochemical, radiological investigations to monitor progress of ones health and well being. Some forms of therapy are not approved by the Australian Therapeutic Goods Administration and have restricted indications and criteria under the Schedule of Pharmaceutical Benefits.Hormones are potent chemicals produced from cholesterol, amino acids and proteins primarily in your endocrine glands and tissues. These glands include the pituitary, pineal, thymus, thyroid and adrenals. Several organs, including the pancreas, ovaries and testes, also contain hormone-producing tissues and are called endocrine organs. In addition, the area of the brain called the hypothalamus also produces hormones, and it is sometimes called a neuroendocrine organ.
Hormones serve as chemical messengers. They circulate through the bloodstream to all of your tissues, but they target only the cells that contain hormone receptor sites specific to that hormone. They then attach to these receptors like keys fitting into locks. Once this "fit" occurs, the cell responds by carrying out what we think of as hormonal activity. Receptor sites for one or more hormones are located on almost every cell in your body, skin, muscle, brain to mention a few. The major areas of biological activity they control are reproduction, growth and development, the stress response, maintenance of blood composition, and metabolism and energy.
Two endocrine organs, both located in the brain, serve as important regulators of the complex hormonal messages traveling from your brain to the rest of your body. The first is your hypothalamus. This walnut-sized area of the brain is considered to be the controlling gland of the endocrine system because it is the central link between your brain and your endocrine system. The pituitary, a pea-sized gland at the base of your brain next to the hypothalamus, acts as a link between the hypothalamus and other endocrine glands throughout your body. It helps to translate messages the hypothalamus is sending.
HORMONE-REPLACEMENT THERAPY (HRT)
HRT in itself is not a new field and has been accepted as a legitimate medical practice of custom tailoring and supplementing hormones that are depleted, unbalanced or non-existent.
Traditionally, doctors have prescribed HRT for Estrogen and Progesterone replacement to ease the symptoms of menopause in women and help minimiSe the risks of Osteoporosis and heart disease.
Conventional hormone-replacement treatment as prescribed by most medical doctors relies on unnatural or synthetic versions of the hormones progesterone and estrogen that are foreign and are now proven to be dangerous to a woman's body.
Conventional hormone-replacement treatment has long been held out to be a women's only choice due to the influence and power of the larger companies. Until now patients have been prescribed synthetic or non Bio-Identical hormones, which are increasingly being rejected by patients due to the adverse side-effects they experience.
Bio-Identical Hormone Replacement provides all the benefits of conventional treatment, but with drastically reduced risks of unwanted side effects and cancer.
While this field is relatively new in Australia it has been recognized in the USA for many years as a legitimate complementary approach to patient care. Many thousands of doctors follow and practise this discipline religiously, owing to the outstanding patient outcomes that they are achieving.
Bio-Identical HRT care goes much further than providing patients with supplement doses of Estrogen, Progesterone, T3, T4 and Testosterone.
WHAT IS BIO-IDENTICAL HORMONE-REPLACEMENT THERAPY?
Hormones for BHRT get their start from the wild yam (Diascorea composite), which is rich in "precursor" molecules easily converted by biochemists into other molecules that are identical in every way to "natural" estrogens, progesterone, testosterone, and other hormones. These plant-derived bio-identical hormones are almost entirely without the side-effects of the synthetic or semi-synthetic HRT drugs commonly prescribed. Synthetic hormone replacement does not allow our body to produce other hormones that are needed to function at full potential.
A Bio-Identical Hormone is defined as a hormone that is biochemically and molecularly identical to the human hormone and that is derived from a plant. Bio-Identical hormones are converted in a laboratory from diosgenin extracted from wild yam and beta-sitosterol extracted from soybeans. Hormones that can be converted from wild yam and soybeans are estrone, estriol, estradiol, progesterone, testosterone and DHEA (dehydroepiandrosterone).
BHRT is the term used to describe the use of bio-identical hormones to replace lost hormones to younger and healthier levels. This is a proven safe and effective treatment in reversing signs of ageing, treating PMT, as well as menopause, in both females and males.
The human body does not have the ability (the required enzymes) to convert diosgenin (a six-ring structure) into pregnenolone (a four-ring structure). Therefore, if you swallow pills that are extracts of wild yams (diosgenin), you will not get pregnenolone or DHEA. The conversion of diosgenin to pregnenolone has to be done in a laboratory.
Hormones do not decline because we age - we age because our hormones decline.
Bio-Identical Hormone Replacement Therapy is not the secret to the fountain of youth - it is the secret to the fountain of "youthfulness".
Decline in key hormones is a primary cause of ageing. Hormones begin to decline in mid-20s. This marks the beginning of the process we know as "ageing".
Wellness and Anti-Ageing
Medical science has determined men and women experience several symptoms because of a decline in key hormones. (In men it is much more gradual, sometimes described inaccurately by media as "Andropause")
The goals of BHRT are to alleviate the symptoms caused by the natural decrease in production of hormones by the body and to bring the body back to hormonal balance. Another goal of BHRT is to imitate the body's natural processes as much as possible, thereby eliminating most of the unwanted effects and long-term risks of the traditional synthetic hormone-replacement therapies.
When describing replacement hormones, the word "Bio-Identical" is used to refer to the structure of the hormone molecule, not its source. When analysed biochemically, the molecules of estrogen, progesterone and other hormones produced from wild yam precursor molecules are found to be absolutely indistinguishable from those the human body produces itself. Thus the crucial variable defining "Bio-Identical" is not the origin of the hormones, but its chemical structure.
Creams and Troches
Creams and Troches prove to be very effective as absorption is through the skin or salivary glands and go directly into the patient's bloodstream, rather than passing through the liver, therefore maintaining first-place effects.
Note: Dosages with creams and troches are often less than the oral dose. As a guide use the following equations.
| Conversion from oral to a cream troche | |
|---|---|
| Progesterone | Use 1/10 |
| DHEA | Use ½ |
| Testosterone | Use ½ |
Mimicking the physiologic release of hormones into the body should be the goal of all Hormone Replacement Therapy (HRT).
Administration of hormones through the skin using percutaneous gels is currently used in Europe. With the possible exception of pellet implants, percutaneous gels offer HRT close to the natural model. Percutaneous gels for HRT are applied to the skin once a day. Studies show plasma values remain constant throughout the day, much like smoking patches used.
Absorption of Hormones
All HRT needs to be individualised for optimal effect. Variances in individual levels due to differences in skin absorption can easily be corrected by simply adjusting the volume or strength of the gel used by the patient for the most optimal effect. The gel dries completely within 1-2 minutes of application leaving no visible trace or smell. Two or more hormones can be combined into a single dose.
WAYS TO APPLY HORMONES
- Creams
- Injectables
- Syringes
- Troches
- Pellet Implants
- Lollypops
- Capsules/Tablets
- Pessaries
TRANSDERMAL HORMONAL CREAM
The major benefit of using a hormonal cream (or troches) compared to hormone capsules is that the amount of hormone required is much less than that required for tablets. Capsulated hormones are actively broken down (metabolised) by the cut wall and liver, which reduces their ability to get to the body cells where they function. Thus capsule preparations of hormones require higher pharmacological dosing in order to achieve a clinical response. Transdermal delivery absorbs more than 90% of most hormones. (Ref. University of Dublin, College of Pharmacology.)
Progesterone, Testosterone and Estrogens are generally administered through topical creams that are absorbed through the skin into the bloodstream circulation and therefore avoid the toxic effects of going through the liver (first-pass metabolism).
Where to apply the cream
For the best absorption creams should be applied to areas where the skin is thin and blood supply is good. Ideal areas include neck, upper chest and inner forearms. Fattier areas such as breasts, stomach, buttocks, etc., will absorb the cream, but metabolism will be slower. Skin needs to be clean and dry. Patients should rotate the areas they choose for application of the creams so that the receptor sites do not get overloaded.
Application will depend on each individual's requirements and response. It is best to apply doses at night before bed. The dose can also be divided into two for administering at morning and at night.
TROCHES
Troches are sublingual tablets that are designed to dissolve in the mouth. Troches are similar to a lozenge and slowly dissolve buccally over approximately 15-20 minutes. Troches ensure that the medication is absorbed directly through the bloodstream, which avoids destruction by the liver. It appears that between the upper cheek and the gum works as the best cavity for the troche to dissolve slowly.
CAPSULES
Because hormones are lipid soluble molecules, oral dosing (capsules) was a problem as the medication would be metabolised out of the body very quickly. However, new micronisation techniques and sustained-release ingredients used avoids this. The slow release gives a more even and consistent release of hormones into the system. Micronised DHEA and pregnenolone are primarily taken by oral capsule dose. Daily dosage depends on the needs and results of a patient.
PELLET IMPLANTS
Pellet Implants typically utilise estradiol, progesterone and testosterone in females. The implants are inserted subdermally (under the skin) every three to six months. HRT mode of administration more accurately mimics the physiologic release of hormones.
Other Dosage Application Forms Available:
- Pessaries
- Suppositories
- Lollypops
GLOSSARY
Adrenal glands: Endocrine glands located on top of the kidneys, which produce steroid hormones, including DHEA (see below).
Alzheimer's disease: A degenerative disease of the central nervous system characterised by premature senile mental deterioration. The disease is named after the German neurologist Alois Alzheimer, who was noted for his work in the pathology of the nervous system.
Andropause: Male menopause.
Antioxidant: A substance that opposes oxidation or inhibits reactions promoted by oxygen or peroxides. These substances are believed to help reduce the damage caused by free radicals released during the oxidation process.
Black cohosh: A herb known to have estrogen-like effects. Used as a traditional remedy for menopausal symptoms.
Climacteric: The transition from reproductive to post-reproductive age.
Circadian rhythm: Rhythm characterised by a 24-hour period or cycle. Generally refers to rhythms in behaviour or physiological activity.
Dehydroepiandrosterone (DHEA): An androgenic ketosteroid produced in the adrenal cortex, gonads and brain. It is a precursor hormone, meaning other steroid hormones are made from it. It is also often called the mother hormone, since it is more prolific than any other hormone produced by the adrenal glands. It is thought to have therapeutic effects in many diverse medical conditions. Low levels of DHEA in the blood are a marker for many degenerative diseases.
Damiana: A herb known to have estrogen-like effects. Used as a traditional remedy for menopausal symptoms.
Dong quai: A Chinese herb commonly used as a female tonic in the Oriental pharmacopoeia. It seems to help balance estrogen levels and has long been used to alleviate menstrual and post-menopausal problems.
Endocrine gland: A gland that produces an endocrine secretion, or a secretion that is distributed in the body by way of the bloodstream.
Endometriosis: The presence of functioning endometrial tissues (the nucous membrane lining the uterus) in places where it not normally found.
Estradiol: One of three major forms of estrogen active in the female body. Usually made synthetically and often used in treating menopausal symptoms. It is the primary estrogen produced in the ovaries.
Estriol: One of three major forms of estrogen active in the female body. It is primarily converted from estrone in the liver and from estradiol by a different route.
Estrogen: An entire group or class of steroid hormones with very similar properties. The three major forms of estrogen active in the female body are estrone, estradiol and estriol. An estrogen tends to promote estrus (heightened period of sexual excitability) and to stimulate the development of female secondary sex characteristics.
Estrone: One of three major forms of estrogen active in the female body. It is made by the adrenal glands and is also converted from estradiol in the intestinal tract.
Follicle-stimulating hormone (FSH): A hormone involved in a woman's menstrual cycle. At the beginning of a cycle, the pituitary gland releases FSH, which stimulates the ovaries to develop and enlarge several follicles, or human egg cells.
Full-spectrum light: Artificial light that is extremely close to natural light because it contains the full spectrum of light waves. Full-spectrum lighting is used to treat seasonal affective disorder (SAD).
HDL Cholesterol: Cholesterol bound to high-density lipoprotein, known as "good" cholesterol because it transports cholesterol to the liver for metabolism and excretion from the body. It actually protects against heart disease.
Hormone: A product of living cells that circulates in the body fluids and produces a specific effect on the activity of cells remote from its point of origin.
Hot flash: A sudden, brief sensation of heat caused by dilation of skin capillaries. Usually associated with menopausal endocrine imbalance.
Human-growth hormone: A hormone secreted in spurts by the pituitary during the early hours of sleep or during exercise or in the case of injury. It is converted into another hormone, somatomedin-C, which is thought to have anti-ageing properties.
Hyperthyroidism: Excessive functioning of the thyroid gland. Also the resulting condition marked by increased metabolic rate, enlargement of the thyroid gland, rapid heart rate and high blood pressure.
Hysterectomy: Surgical removal of the uterus.
Jet lag: A condition following long airline flights through several time zones and characterised by various psychological and physiological effects, such as fatigue and irritability. Probably results from disruption of circadian rhythms in the human body.
LDL cholesterol: Cholesterol bound to low-density lipoprotein. Often referred to as "bad" cholesterol because it transports cholesterol to the body tissues and increases the risk for heart disease, stroke and high blood pressure.
Leutinising hormone (LH): A hormone involved in a woman's menstrual cycle. During mid-cycle, an increase in LH causes ovulation.
Luteal phase: A part of a woman's menstrual cycle. During this phase, blood vessels and connective tissues in the lining of the uterus proliferate, readying the uterus for implantation of a fertilised egg.
Melatonin: A hormone produced by the pineal gland, which plays a significant role in regulating the body's sleep/wake cycle. It is also thought to play a role in ageing and is recognized as a powerful antioxidant.
Menopause: The cessation of menstruation. Usually occurs between the ages of 45 and 50 and results in a decline of hormones, most notably estrogen. Low estrogen levels often lead to a variety of physical and emotional changes.
Natural thyroid hormone: Hormones secreted by the thyroid gland that regulate metabolism. High levels of thyroid hormone are associated with hyperthyroidism and low levels are associated with hypothyroidism.
Neuroadaptogen: A substance that balances and brings into harmony organ function. The hormone pregnenolone is characterised as a neuroadaptogen.
Neurohormone: A hormone produced by or acting on nervous tissue.
Neurosteroid: A steroid hormone produced by or acting on nervous tissue.
Night sweats: Profuse sweating during sleep that is a common symptom of menopause and is thought to be caused by a hormonal imbalance.
Osteoporosis: A condition characterised by a decrease in bone mass, resulting in porous and fragile bones. Low levels of estrogen and progesterone are thought to contribute to this debilitating disease.
Phytoestrogens: Compounds found in certain plants and that have estrogen-like properties.
Pineal gland: A pea-sized gland located deep in the brain that produces melatonin and is thought to be key in regulating circadian rhythms. The gland is sensitive to light and has pigment cells like those in the eyes.
Pituitary: A small, vasculate endocrine organ located in the brain that regulates hormones that directly or indirectly affect most basic bodily functions.
Precursor hormone: A hormone that is at the top of the hormonal cascade, meaning other hormones originate from it.
Pregnenolone: A steroid hormone produced by the adrenal glands and synthesised directly from cholesterol. It is a precursor hormone, from which all other steroid hormones are made.
Progesterone: A hormone produced by the adrenal glands in the ovaries during childbearing years, and in the placenta during pregnancy. It is integral to the menstrual cycle and pregnancy. Progesterone imbalances are often associated with premenstrual syndrome.
Provern: The most popular brand of conjugated estrogen, which is made from the urine of pregnant mares.
Premenstrual syndrome: A syndrome associated with too little of the hormone progesterone and a resulting imbalance between estrogen and progesterone. Symptoms include cramps, emotional swings, painful breasts, food cravings, weight gain and bloating.
Recombinant DNA biotechnology: Technology in which specific DNA is inserted into bacteria where it is rapidly reproduced.
Seasonal affective disorder (SAD): A disorder caused by an alteration in the body's circadian rhythm, usually occurring during the shorter days of autumn and winter. Symptoms include feelings of depression, fatigue, sleepiness, carbohydrate cravings and weight gain. Symptoms can often be relieved with full-spectrum light therapy.
Steroids: Any of numerous compounds containing a 17-carbon four-ring system, including a variety of hormones.
Somatomedin-C: A hormone derived from human-growth hormone. It is thought to have remarkable anti-ageing capabilities.
Testosterone: One of several anabolic androgenic steroidal hormones produced by the adrenal cortex. When males reach puberty, the testes take over testosterone production and significantly increase its output. It has androgenic, or masculinising effects and anabolic, or tissue-building effects.
Tincture: A liquid suspension solution.
Transdermal cream: A cream that is applied via the epidermis, or skin.
Tri-estrogren: An estrogen replacement therapy formulated by Jonathan Wright, M.D., containing 80% estriol, 10% estrone and 10% estradiol.
Tryptophan: An amino acid which, in supplement form, is very helpful for sleep problems, depression and anxiety. It was pulled from the market in 1989 when several hundred cases of a relatively new disorder - eosinophilia-myalgia syndrome -were attributed to the supplement.
