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Note: The following blog is rather extensive. It contains most of the basic information you need regarding female and male hormones (both bio-identical hormones and the regular/conventional hormones), including how to properly test and balance them in order to prevent as well as treat a variety of hormone-related conditions such as menopause, hormonal cancers, cardiovascular disease, etc. This blog also briefly covers a few other miscellaneous hormone-related topics including thyroid hormone imbalance, infertility, the role sex hormones play in osteoporosis, the popular over-the-counter hormone DHEA, and more.

I recently had the fortune of attending a 4-day symposium in San Francisco taught by the most famous and credible doctors in the country and possibly the world on the subject of BHRT (Bio-identical Hormone Replacement Therapy) or “natural” hormones (as opposed to the conventional synthetic ones). Consequently, I decided to summarize some of the practical tips offered at this symposium for you all, in hopes that you will gain a deeper understanding of this most important subject.

One of the most noteworthy subjects that was covered at this symposium was that, to say the least, women going through menopause (or women who are post menopausal or experiencing other hormonally-related problems) and men going through andropause (or men experiencing other hormonally-related problems) should have their hormones tested using a comprehensive URINE or SALIVARY (NOT BLOOD) hormone test to make certain the proper RATIO (THIS IS KEY) of “steroid” hormones (estrogen, progesterone, testosterone, cortisol, DHEA, DHT, and all their metabolites) are present in their body. Specifically there are various types of estrogen, some are considered to be definitely “protective” which balance the other types of estrogen that may be more questionable when out of balance.

To give you a bit of a background on the subject, naturopathic doctors and even some (although in the minority) alternative-minded medical doctors and other health care practitioners who are interested in more of a natural approach to hormone balancing have for years been recommending BHRT (Bio-identical Hormone Replacement Therapy) instead of the regular “medical HRT” (HRT stands for Hormone Replacement Therapy) which are synthetic horse-derived hormones (such as Premarin, Provera, and Prempro).

A bit more history…. Women’s Health Initiative (WHI), a wide-scale study conducted nearly 10 years ago, associated the use of medical HRT (Hormone Replacement Therapy) with various types of female cancers and cardiovascular disease among other diseases. Since then, many doctors are concerned about prescribing female hormones, and many patients are fearful of taking such hormones. The problem here is that the hormones studied were animal-derived (specifically horse) synthetic hormones, NOT bio-identical hormones (which are identical to human hormones, molecule by molecule). Medical HRT used in the Women’s Health Initiative contained synthetic progesterone called “progestins”, and synthetic estrogen also known as “conjugated estrogens”. It is critical to note that no studies so far over the last nearly couple of decades seem to have associated BHRT (Bio-identical Hormone Replacement Therapy) with increased risk of cancer or other diseases. In fact, many BHRT studies prove that such natural hormones are often necessary for their health promoting properties.
(An interesting side note: Researchers have found that synthetic progesterone, called progestins, block the beneficial effects of the women’s own healthy estrogens in their body.)

To make matters more complicated, there are a variety of views among NDs (Naturopathic Doctors) on the subject of BHRT. Some NDs are against BHRT, probably for similar reasons as the public since they are basing their opinions on the Women’s Health Initiative research study which was conducted close to 10 years ago, proving that “medical HRT” or horse-derived hormones (as opposed to BHRT, which are natural hormones) was definitely risky business, and women should ideally not be using hormones. Other NDs just don’t believe there is anything “natural” about any kind of hormone replacement therapy even BHRT since hormones are powerful chemicals, versus more gentle therapies such as herbs or nutrients. However, there is yet another class of NDs who have and continue to promote the use of BHRT. It is for this very reason I attended the latest BHRT symposium recently, to learn more about all the latest actual scientific research findings on the subject. And, sure enough, there has been plenty of work done on the subject by the scientific community literally worldwide on the subject of BHRT over the last number of years since the Women’s Health Initiative (which again condemned HRT, the synthetic horse-derived hormones) trying to shed light on the above dilemma- “Is BHRT also bad for us, like HRT?”
The short answer is “no, BHRT is not bad. In fact, BHRT is often necessary for disease prevention as well as treatment in both genders.”

So far in my practice, I have prescribed BHRT (FYI, hormones are prescription items, even the natural ones) to some of my female patients who were clearly suffering from menopausal symptoms, including hot flashes, night sweats, mood swings, weight gain, hair loss, fatigue, poor libido, etc. Based on the research that has been done over the last nearly couple of decades, BHRT can be effectively used for treatment of a variety of other conditions such as hypertension, high cholesterol, brain fog, poor memory, osteoporosis, migraines, urinary incontinence, and even a lung disorder such as COPD.

There are three types of human estrogens: estrone (E1), estradiol (E2), and estriol (E3). However, there is only one type of progesterone, and one type of testosterone. Note, however, that estrogen, progesterone and testosterone break down to various chemicals in the body known as their “metabolites”.

In order to share information on the safety of BHRT (or natural hormones), I would like to site one large scale study here. The Fournier study conducted in 2007 involved 80,377 postmenopausal women. There was no increase or decrease in breast cancer in women on estradiol and progesterone (both being “good” human hormones). However, the women on E2 (“good” human estrogen) plus Provera (the “bad” animal derived progesterone) had 69% increase in risk of breast cancer. This study clearly illustrates the difference between natural or bio-identical progesterone and the animal-derived type of progesterone called Provera which is a type of progestin. Clearly, the bio-identical kind was proven to be safe, and the animal-derived type did not.

Specifically, progestins (the “bad” progesterone) negatively impact our cholesterol profile and brain health, and cause a variety of other side effects including breast tenderness, bloating, increased appetite, decreased libido, acne, hair loss, depression, insomnia and irritability.

Progesterone (which is what human beings, even men, have in their bodies), on the other hand, helps our heart to receive better blood flow, has protective effects on the brain, increases metabolic rate (causing weight loss), promotes sleep, is calming, and can act as an anti-depressant. Progesterone has always been considered a “protective” female hormone, so this is not new information.

I would specially like to point out that horse progesterone (found in various hormonal methods of birth control including the pill) can cause depression, but human progesterone is known to have an antidepressant effect on women. I have seen many patients who once they stop birth control pills, their depression lifts! (Refer to the Birth Control page on my site for actual patient videos where patients share their negative experiences with birth control pills.)

Numerous studies have recently shown that in addition to human progesterone, human estrogen (i.e. natural, bio-identical estrogen) may also reduce the risk of various diseases including various female cancers and heart disease. The way human estrogen therapy can help protect against various types of cancers is by balancing the various types of estrogens. Heart disease risk has been shown in studies to be reduced by 50% in postmenopausal women.

Some opponents of hormone replacement therapy assert that with the aging process, most (if not all) of our hormones decline. They say that it is “natural” to get old and have lesser amounts of hormones in our bodies. That is certainly true. We can also say, however, that it is natural to die at some point as you age. And, that is true too. However, it is certainly an option to BALANCE your hormones so that you age in a healthy way. If your body is desperate for some particular type of hormone (which you can find out by a comprehensive hormone panel), I not only don’t believe it would be hurtful to take that hormone as a prescription medicine, I actually believe it would be highly beneficial to do so. And, so the research says.

Some proponents of hormone replacement therapy say that WE AGE BECAUSE OUR HORMONES DECLINE, OUR HORMONES DON’T DECLINE BECAUSE WE AGE. Although aging does decrease our hormones, we can prevent the acceleration of this process, and potentially even increase our hormone levels by various means, including exercise, proper diet, indicated supplements, and BHRT (Bio-identical Hormone Replacement Therapy).

The efficiency and safety of long-term use of hormone prescriptions (i.e BHRT) should be confirmed using periodic URINE or SALIVARY hormone tests as opposed to BLOOD tests. Conventional medical practitioners have so far ordered blood tests to measure the levels of our sex hormones estrogen, progesterone and testosterone. However, we are finding that blood tests of our sex hormones do not reveal values that are reliable indicators of the actual levels of these hormones in our entire body. Urine and salivary tests, however, do seem to provide rather accurate estimation of the levels of these hormones in our body. Urine sex hormone testing provides more information that salivary; specifically the urine testing shows all the steroid hormones and their metabolites (breakdown by-products), but the salivary testing does not show the metabolites which is necessary information for proper treatment. Therefore, I would recommend the urine steroid hormone testing over the salivary one. (Note that with the cortisol test, in particular, we can still use the salivary test which is very accurate.)

It is very important to note that since bio-identical hormones (women’s as well as men’s) are literally identical (molecule by molecule) to our own innate human hormones, they can NOT be patented. Any substance found in nature (or identical to it) cannot be patented by pharmaceutical companies because they did not invent the chemical formula for that hormone– they merely copy the blueprint nature has already provided for them. However, if a drug company chemically modifies a hormone’s structure in a unique fashion, or develops a new formulation/system for a unique delivery method of a hormone, that company may apply for a patent for that drug. If their newly-created drug is approved by the Food and Drug Administration (FDA) for safety and their patent is accepted, they may then profit solely from the drug’s manufacture for a number of years before other companies can create generic or brand-name equivalents. In this light, it is clear why BHRT is not yet widely accepted by the conventional establishment.

In all fairness, I should point out that it is true that sometimes drug companies modify a particular formulation found in nature to make it more effective. Sadly, that is not the case with hormones. Modifying human hormones does not seem to make them more effective- it makes them more toxic and dangerous. And, using horse hormones is clearly a very obvious tactic (definitely an inhumane one) that drug companies have used to make profit.

You may be interested to hear that over 95% of the attendees at this recent BHRT symposium in San Francisco were actually medical doctors, and there were only a few naturopathic doctors present in the audience. Among the audience, there were MDs from various sub-specialities, including OBGYN. Therefore, it seems that more and more conventional practitioners are joining the BHRT movement which is wonderful since we truly must put an end to the barbarian perspective on HRT for women, i.e. the use of horse-derived hormones which we have seen can kill or seriously harm women.

The lecturers at this symposium were all medical doctors, some of which are internationally known for their work in the field of hormones. They shared the latest research on the subject, coming out of many countries, including United States. The latest research clearly shows the beneficial effects of BHRT on both genders.

More details on the different forms of estrogen (be it the form that is found in our bodies or the form that we can take as medicine). Again, there are three types of estrogen: estrone (E1), estradiol (E2), and estriol (E3).

Estrone (E1) itself has three subtypes: 2 hydroxyestrone (2OH) E1, 4 hydroxyestrone (4OH) E1, and 16 alpha hydroxy (16aOH) E1.

Estrone (E1) is the form that we want to control as far as metabolism. This is a complex biochemical issue but all we need to understand from our physical and health standpoint is how to limit the 4OH-E1 and the 16aOH-E1.

The 2OH-E1 is benign in the body and is not linked with diseases like cancer and metastases. In fact, the 2OH-E1 is considered to be a “good” estrogen. MTHF (methylated form of folic acid), omega 3’s, vitamin B6, vitamin B12, folic acid, DIM, and cruciferous vegetables increase the levels of 2OH-E1 in our body.

The 16aOH-E1 is mutagenic (can alter DNA unfavorably, and has been associated with an increased risk of breast cancer in women), but we can further its metabolism and excretion into a benign substance by supplying enough B-vitamins and “methyl donors”. These methyl donors are nutrients that we can increase through supplementation which allow the 16aOH-E1 to become the benign form at a much higher rate and percentage. You see if we ingest enough of these “methyl donors” we push the metabolism of the 16aOH-E1 further to the good “estriol” (E3). So to highlight this very important point, even though the 16aOH-E1 is not considered to be a “good” estrogen, it can sometimes be used by the body to convert to a “good” kind of estrogen, E3 (refer to the estriol or E3 paragraph below).

In men, higher levels of 16aOH-E1 has been correlated with higher prostate cancer risk.

The 4OH-E1 is carcinogenic in the breast (male and female breast) and mutagenic as is the 16aOH-E1. The great thing here is that although this sounds complex, we once again need to SIMPLY ingest more “methyl donors” and antioxidants into our diet. When we do this, the “methylated” form of 4OH-E1 (4-hydroxyesterone) becomes 4-methoxyestrone and is benign once again.

So the two “bad” subtypes of esterone (E1) are the metabolites 4OH-E1, and 16aOH-E1. Methylators allow the metabolism of both of these mutagenic and carcinogenic substances to their benign end-point which are then excreted from the body.

what are these methylators? Here they are:

Vitamin B6 (pyridoxine)
Vitamin B12 (cyanocobalamin)
SAMe (s-adenosylmethionine)
Folic Acid
Vitamin B5 (pantothenic acid)
Indole-3-carbinol (I3C) or Di-indolmethane (DIM)

Estradiol (E2) is the most potent female hormone and the one that we would like to limit from excess production. Estradiol is about 10 times as potent as estrone (E1) and about 80 times as potent as estriol (E3) in its estrogenic effect. E2 is the predominant estrogen during reproductive years both in terms of absolute serum levels as well as in terms of estrogenic activity. During menopause, E1 is the predominant circulating estrogen and during pregnancy E3 is the predominant circulating estrogen in terms of serum levels. Estradiol is also present in males, being produced as an active metabolic product of testosterone. The serum levels of estradiol in males are roughly comparable to those of postmenopausal women. Estradiol has not only a critical impact on reproductive and sexual functioning, but also affects other organs, including the bones.

Estriol (E3) is considered to be a more desirable form of estrogen; it is less active than estradiol (E2), so when it occupies the estrogen receptor it effectively blocks estradiol’s strong “grow” signals. E3 is 80 times weaker than E2, and offers breast cancer protection. E3 can control menopausal symptoms without causing uterine lining growth. It can also help increase bone density in women. E3 suppositories work nearly 100% effectively in helping with vaginal dryness that is such a widespread problem particularly among post-menopausal women. The stronger form of estrogen (E2) can be converted into the weaker form of estrogen (E3) without using drugs. Using a natural substance (IC3 or DIM), researchers have been able to increase the conversion of E2 to E3.

Can you figure out your risk of breast cancer? Well, there are definitely ways that have been proposed for this purpose. One such way is what is known as the estrogen quotient (EQ) which was developed by Dr. Henry Lemon. EQ can be calculated with the results of the levels obtained from 24 hour urine hormone testing. Remember E3 is a “good” estrogen. “More E3 means less cancer risk. Estriol (E3) appears to block many of the effects of estradiol (E2), estrone (E1), and other “pro-carcinogenic” estrogens. So how do you find out if your body is producing enough estriol to protect you from cancer? You calculate your EQ. Dr. Lemon tested estriol along with estrone and estradiol by having women collect their urine for 24-hours, then measuring the hormone levels in the specimens. It’s still done the same way, although some changes in the actual testing equipment have made the process a lot easier. Even though you’ll need to collect all your urine for a 24-hour period, only a small amount is actually mailed in for testing. If you haven’t gone through menopause yet, and you have a menstrual cycle that follows the typical 28-day pattern, pick a 24-hour period between days 19 and 23 of your cycle (day 1 being the first day of menstrual bleeding) to collect your sample. If you’ve already gone through menopause, you can collect your sample anytime. Once you send your sample back to the lab, it generally takes about two to three weeks to get your results. When your results arrive, you’ll see all of your different hormone levels listed. The ones we’re most concerned with for determining breast cancer risk via the EQ are E1, E2, and E3. Remember, it’s not the absolute amount of E3 that appears to be the most important number but the relative amount of E3 compared with the sum of E2 and E1. In mathematical terms, it looks like this: EQ= E3 / (E2 + E1).

If the ratio of your estrogens is out of balance, you can of course help correct the ratio by various means including BHRT (i.e. by taking various hormones via pills or creams, or other methods of administration) or even more simple supplements including the SSKI. SSKI is a solution that combines iodine and potassium. It’s the iodine that works to boost the EQ: Iodide (and iodine) reliably promote the metabolism of estrone and estradiol into estriol (the “good” estrogen). The typical dose is six to eight drops of SSKI mixed in several ounces of water daily for two to three months. Then repeat your test, doing the 24-hour urine collection at the same time of the month as your first one. More likely than not, your follow-up EQ will be above 1.0-sometimes considerably above. If it is, try tapering down the SSKI to the smallest amount that helps you maintain your EQ at 1.0 or above. Some women find that they only need one drop a day, though others need more. On rare occasion, long-term use of larger quantities of SSKI may cause thyroid suppression. Thyroid blood tests should definitely be ordered if taking SSKI.” (Dr. Jonathan Wright, MD)

A question that comes up quite often is that “should women who have had their uterus removed take natural progesterone?” Most conventional medical doctors have so far believed that there is no need for progesterone if the woman has no uterus. However, we know that there are progesterone receptors on every cell in the body, not just in the uterus. And, women, even those without a uterus, seem to benefit greatly from this safe female hormone.

Hormone balancing for men…. should men be concerned about their sex hormones? The answer is Yes. Andropause (mens’ menopause) is associated with testosterone deficiency. Testosterone deficiency has the various signs and symptoms: Increased aging and functioning of the heart, increased brain aging, loss of drive and competitive edge, stiffness and pain in muscles and nerves, falling level of fitness, decreased effectiveness of workouts, less muscle & more fat, osteoporosis, anemia, fatigue, depression, mood changes, irritability, and reduced libido and potency.

How about using testosterone as a medicine? If you have followed the media recently, you have probably heard all the news on how administration of testosterone can have hazardous health consequences. A few pointers here are: First, if you (men or women) are using testosterone, it should definitely be the bio-identical kind. Some of the conventional forms of testosterone (which are not bio-identical) have been associated with an increase in liver cancer, and potentially other diseases. Second, if you are on testosterone (man or woman), the levels of the female hormones should be optimized/balanced. Otherwise, higher than normal levels of testosterone (without the estrogen levels being balanced) can have negative side effects. Specifically, in order for testosterone to work well, estradiol (E2) must be optimized. Third, the recent studies that have shown testosterone therapy having negative health consequences appear to have been poorly designed. (This discussion is beyond the scope of this blog.)

If you are a man, you might be wondering “does testosterone therapy cause prostate cancer?” The answer is “no”. There is no evidence testosterone therapy causes prostate cancer. In fact, low testosterone is more highly associated with prostate cancer.

DHT (dihydrotestosterone) may be thought of as the “bad” testosterone since too much DHT has a variety of side effects such as hair loss, BPH (enlarged prostate), AND CAN EVEN PUT MEN AT RISK FOR PROSTATE CANCER. Therefore, men should have their DHT as well as their testosterone levels checked.

A particular hormone that many of you might not have heard of is DHEA. DHEA can be found as a supplement in health food stores. Since DHEA is a precursor to our sex hormones (estrogen, progesterone and testosterone), some people wrongly believe that by taking this supplement, their sex hormone deficiencies may become corrected. Even though the above thought is partially true, you most definitely can’t expect this supplement to provide much of the actual hormones estrogen, progesterone and testosterone. Note that lower than normal amounts of DHEA has been associated with cardiovascular disease among other conditions. Therefore, you should know your DHEA levels, and correct any deficiencies by supplementation.

An interesting side note is that for optimal levels of libido (i.e. sex drive), men need optimal levels of estrogen (in particular E2), and women need optimal levels of testosterone.

The method of administration of the hormones matters, and has evolved through the years. It turns out that for progesterone, the oral as well as the cream form are both considered effective. However, for estrogen, researchers have found that the topical route (as opposed to oral) is the preferred method of use. Therefore, if you have been taking oral estrogen (in any form, in particular in the estradiol form), it’s advisable to switch to the topical form. The wrong hormones and the wrong method of administration can cause adverse effects. Therefore, if you have not been in to see your naturopathic doctor (or whoever has recommended your BHRT protocol), you should definitely make an appointment to have 1) your hormones checked and analyzed 2) make sure you are taking your BHRT in the right form (cream versus pill).

Note that transdermal (or skin) absorption slowly declines over time. However, mucous membrane absorption will stay good over time. The recommended areas for application of some BHRT formulations for both genders are mucous membranes, the labia/vaginal area for women and the anus for men. You should discuss this subject further with your doctor.

Should you take BHRT all month long without interruption? Recent findings suggest that it’s wise for women to take a break from BHRT a few days a month. The reason is that during women’s menstrual cycle, estrogen and progesterone fluctuate. It’s recommended that you take progesterone the 2nd half of the cycle if you are still menstruating (and ideally avoid taking it for 1-2 weeks out of the month if you are not menstruating). Note that some women feel that they need to take progesterone most of the month. If that is the case, you should definitely consult with your doctor. Additionally, it’s recommended that women take a few days off of their estrogen use, say the first few days of the month. This recommendation is based on the idea of copying nature. With men, they don’t have the fluctuations, their testosterone tends to be at a steady level the entire month. Therefore, testosterone administration does not have to vary throughout the month.

A critical subject to discuss at this point is that whether you are on any hormone replacement therapy or not (but specially if you are), and regardless of your gender, you should definitely be on a liver cleansing/detoxification protocol advised by your alternative health practitioner (as most MDs do not believe in organ detoxification yet despite overwhelming evidence for the existence of toxins in out environment). The reason is that excess hormones get cleansed out of the body by the liver, and a poorly functioning liver will not be able to properly eliminate excess hormones, some of which may be hazardous to your health as discussed above. And, remember just detoxifying the liver for two weeks every six months or a year is not sufficient. If on BHRT, or if suffering from any chronic diseases at all, or if interested in preventing any chronic diseases in general, at least a few weeks of liver (and ideally even intestinal and kidney detox) out of every single season is an MUST for health maintenance. Lastly, milk thistle which is well known herb for its ability to cleanse the liver is NOT the most effective way of doing liver cleansing. (Discuss your various options with your ND.)

Let’s further discuss the subject of birth control methods as it is completely relevant to the subject of this blog. Most NDs as well as other alternative minded practitioners including wholistic MDs do not recommend the use of birth control methods of any kind including the pill, hormonal IUD or the DEPO shot. We should discuss a few additional reasons as to why such hormonal interventions are hazardous to women’s health:

WOMEN ARE NOT HORSES, THEY ARE HUMANS! It simply does not make any sense for women to take horse hormones. Aside from the fact that horse-derived hormones are difficult for our liver to process, and thus can create havoc in our digestive system, they have also been shown to definitely cause various forms of cancers in women. Something you don’t hear much about, however, is that taking birth control pills can cause women’s LIBIDO TO DECLINE, and this side effect can in some cases be IRREVERSIBLE! The mechanism by which this occurs is the following:

Birth control pills increase what are known as SHBG (Sex Hormone Binding Globulins) which lower women’s testosterone levels. Lower testosterone levels are associated with poor libido, vaginal atrophy and pain. If you happen to have suffered from this complication, a possible solution is to 1) stop the birth control medication (be it oral or IUD or shot) 2) consider testosterone injections.

Are there natural hormonal methods (such as BHRT) for birth control? No. No human hormones can stop pregnancy from happening. Only horse hormones can stop humans from getting pregnant. The only “natural” methods include the mechanical methods of birth control such as the condom, diaphragm, non-hormonal IUD, or any combination of the above.

Even if you are the type of individual who is 100% against taking any hormones (even after reading this blog so far), you should still consider doing the 24 hour urine hormone test anyway. Again, you will find out which hormones may potentially be deficient. And, you can help correct those deficiencies or hormone imbalances by other non-hormonal means such as consuming cruciferous vegetables, or taking various supplements such as B vitamins, DIM, or iodine/iodide (SSKI) discussed above. Note that you can also help increase LOW estrogen levels by taking vitamin A, boron (which is a mineral), and spearmint or mint tea. Mint in some studies has been shown to decrease testosterone levels in men. Does this mean men shouldn’t drink mint tea since it might increase their estrogen levels and decrease their testosterone levels (the opposite of what they would ideally want), or should women not drink mint tea regularly since it can potentially elevate their estrogen levels to excess putting them at risk for various cancers? I don’t believe we can answer these questions conclusively at this point (due to lack of large scale studies), but based on some information from a few studies, it is advisable to avoid daily and regular consumption of mint tea in the U.S. due to our estrogenic Western diet.

How about infertility? If you happen to be infertile (a man or woman), doing a urine or salivary hormone test is absolutely critical. Do not just rely on the conventional blood tests in this case. Additionally, if you are interfile, you should also do a hair mineral test to find out how well you are absorbing nutrients from your diet. Often ladies who are labeled infertile become pregnant by just having their thyroid and/or sex hormones balanced the right way. (A completely different side note: I have successfully treated a number of female patients with complaint of infertility using diet and homeopathic remedies alone. You can google this subject if you are interested.)

How about testing your adrenal glands (which synthesize cortisol)? In this case, a urinary or salivary test may be ordered. Blood testing of cortisol levels is basally completely useless unless you have extremely rare disorders of the adrenal glands known as Addison’s or Cushing’s disease. The point that is of significant importance here is that the conversion of T4 to T3 is inhibited by cortisol (hormone of stress), sugar, organ dysfunction, inflammation, and fasting. So, if your thyroid numbers are not within optimal range, you may benefit from balancing your adrenal glands to lower the cortisol levels (again because cortisol negatively impacts our T4 to T3 conversion).

Since we are discussing the various hormones, it seems relevant to also touch upon the thyroid gland even though the thyroid hormones are not “steroidal” hormones (sex hormones as well as cortisol are called steroid hormones.) it’s noteworthy to mention that to have a through view of your thyroid gland function, you should definitely have your doctor order more than just the TSH (thyroid stimulating hormone) test which is often the ONLY thyroid test that is ordered by most conventional doctors. You should have the following tests included in your thyroid panel of tests: free T3, free T4, reverse T3, and thyroid antibodies (anti-TPO and anti-TBG). To share with you how these other tests can provide critical information, I will suffice to mention a few facts: A low T3 is a strong predictor of death in patients with cardiovascular disease. Reverse T3 will occupy the place of T3 (the main thyroid hormone that our body desperately needs), so we don’t want too much reverse T3. Note that our thyroid gland synthesizes T4, but then our body has to transform our T4 to T3 which is the main hormone that does the actual work of making sure our cells are providing enough energy for us. One could have high T4, but low T3, which is not an ideal situation since we need adequate amounts of T3 to function. (The synthetic thyroid hormone called Synthroid is T4.) It’s not too uncommon for me to have patients with perfect TSH levels, and abnormal values for the other parameters listed here.

There are various nutrients that can easily be taken orally to balance our thyroid hormones without or along with thyroid hormones. (Refer to my thyroid blog.) To name a few, iodine, l-tyrosine, selenium and zinc are critical for thyroid hormone synthesis and conversation (of T4 to T3). There are numerous herbs and homeopathic remedies that can also be used to treat improper thyroid function.

Optimizing thyroid function can help reduce obesity and syndrome X and lipids/cholesterol. It has been shown that T3 optimization improves congestive heart failure as well as neurodegenerative processes (i.e. processes that degenerate nerves) and cognitive impairment.

A condition that deserves attention by itself here is osteoporosis since our bone health is impacted by our hormones. As stated earlier in this blog, BHRT can be used in treatment of osteoporosis. Although osteoporosis is often associated with the female gender, males can also suffer from osteoporosis. And, hormone balancing in both genders has been shown to be beneficial in treating and/or preventing osteoporosis.

Note that besides the bone scan, there is another simple test that all women, regardless of insurance coverage, should definitely consider requesting. This test is the urine NTx test. This test tells us how much calcium is coming out of a person in his/her urine. Women at risk for osteoporosis should have their urine NTx levels tested a few times a year.

Regarding osteoporosis, there are numerous natural supplements that can help improve this condition. Most notably appears to be strontium. High doses of this nutrient appears to have a an extremely positive effect on our bone density. Discuss the dosing with your naturopathic doctor.

One miscellaneous useful tip I learned at the symposium was that women with urinary incontinence could benefit from applying estriol (the “good” form of estrogen, otherwise known as E3) topically onto their vaginal/labial area.

Interestingly, I had been treating a post-menopausal patient with chief complaint of high blood pressure for a couple of weeks prior to the symposium with minimal success. Her health appeared to be wonderful other than the fact that her blood pressure could not be controlled. Prior to seeing me, she had already tried two different pharmaceutical drugs without any success. I had offered her an exhaustive list of various natural therapies that I typically recommend to patients with high blood pressure in order to help lower her blood pressure, but had only achieved minimal success in her case. After I returned from the symposium, she happened to have a follow up visit with me, where I discovered that her blood pressure in my office was 190/100 which is dangerously high. I offered her a safe and easy BHRT program which involved the use of a topical cream with minimal amounts of progesterone and estriol (E3, the good estrogen). Much to our amazement, her blood pressure decreased within a few hours, and was perfectly normal within 24 hours, and has basically stayed normal over the last couple of weeks since the onset of the BHRT treatment. Of course, she and I are both extremely pleased with the results. The possibility of using safe and effective BHRT protocols to address various health conditions such as high blood pressure, high cholesterol, etc., opens up an entirely new and exciting area of medicine.

In conclusion, as you can see hormones are necessary for proper functioning of the entire body, including all the systems and tissues. They must all be in balance; otherwise, we can suffer from rather serious consequences including cancer and heart disease, the top diseases associated with morbidity and mortality in the world (Notice I did not call these diseases the top “killers” as I believe the top killers are not these diseases; they are the poor lifestyle and dietary choices we make such as not exercising, not leading happy and joyous lives, not sleeping enough, not knowing how to handle stress effectively, cigarette smoking, not drinking enough water, not eating sufficient amount of vegetables, eating too much junk food, consuming hazardous pharmaceutical drugs year after year, etc.) I would like to emphasize that you should definitely do a 24 hour urine comprehensive hormone test

1) If you are presently taking female and/or male hormones (This is specially important if you have been on BHRT for a while- we would need to monitor your levels to make certain you are not over or underdosing.)

2) If you have any conditions that you know or think may be hormonal such as infertility, menopausal symptoms, irregular periods, poor libido, hair loss, inability to lose weight despite of working out and dieting, etc.

3) If you suffer from generalized symptoms such as fatigue or insomnia, or any mood conditions such as depression or anxiety

4) If you have challenging acute or chronic conditions that no doctor seems to be able to help you with such as uncontrolled high blood pressure or cholesterol, unrelenting migraine headaches, etc. Chances are your hormones are off balance.

In health,

Dr. Sharif