Bio-Identical Hormones

By Dr. Sanjay Mohan, B.Sc.(Hon.), N.D.

What are Bioidentical hormones?

Bioidentical Hormones are hormones which have the exact same molecular structure as the hormones which you naturally produce in the body. These hormones are powerful chemical messengers, but they are made with natural ingredients and are prescribed by Naturopathic Physicians. Basically, Natural Hormone therapy replaces the human hormones, e.g. bioidentical estrogen and progesterone, which decline as the ovaries and testicles stop making them as people age. They are available as routine prescriptions through a compounding pharmacist, whom receive more advanced training after graduation. There are many different dosages, types and combinations of bioidentical hormones. As such, a Naturopathic Physician will go through a comprehensive individual medical assessment, test you for the levels of your hormones and based on the test results, will be able to customize a treatment plan of specific bioidentical hormone or hormones for you.

How can Bioidentical Hormones help?

There are many benefits to using Bioidentical Hormones, namely:

  • Helping improve mood by alleviating depression, anxiety or mood swings
  • Helping decrease the risk of osteoporosis while increasing bone density
  • Helping improve cardiovascular health and prevent heart disease
  • Helping the body get into proper sleep/wake cycles or circadian rhythms
  • Helping decrease wrinkles by increasing the deposition of collagen and elastin in the skin
  • Helping improve the immune system fight off infections or repair damaged tissues
  • Helping with weight loss by increasing healthy muscle mass
  • Helping with hair loss and dry skin
  • Helping improve memory and mental acuity

Why are bioidentical hormones controversial?

As men and women enter their 40’s and 50’s, the bodies’ production of hormones estrogen, progesterone, testosterone and other hormones which help maintain youthful vitality, decreases. The individual effects of menopause and andropause vary widely as the bodies no longer produce the sex hormones at sufficient levels to optimally maintain physiological processes. Depression, irritability, declining memory are common symptoms as humans age. For menopausal patients, hot flashes, night sweats, insomnia and weight gain are all common

There are health problems which can adversely affect a man or woman for the rest of their life in the absence of apt levels of hormones. Patients are often told by other health care professionals to limit the use of hormone drugs, only long enough to obtain relief from their symptoms and nothing more. However, this information does not take into account the different between bioidentical hormones and synthetic hormones.

Conventional hormone replacement therapy, called HRT, uses synthetic hormones which are produced in a laboratory and patented by pharmaceutical companies. For example, Premarin, a common HRT, is an estrogen derived from pregnant horse urine; Provera is a synthetic progesterone that is commonly used. Premarin contains 9 molecules unrecognizable by the human body, including a hormone called equilinin, which is known to be dangerous. For many decades, the drugs were marketed to female patients by the drug companies, but neither patients nor their prescribing physicians fully understood the risks and benefits associated with synthetic hormones. In comparison, Premarin and Provera are NOT the same as bioidentical estrogen and progesterone.

In the summer of 2002, there was a key setback in thinking among health care professionals following the release of information from the Women’s Health Institute (WHI) and the Journal of the American Medical Association (JAMA). The WHI was a 15-year national health study involving 161,000 women, ages 50 to 79 in the United States. The study explored the risks and benefits of synthetic estrogen plus progestin in healthy postmenopausal women.

The arm of the study using Premarin and Provera was discontinued early when an increased risk of breast cancer was detected in study participants. The arm of the study using Premarin was discontinued because of an increased incidence of strokes and blood clots in older women. Following the release of these results in 2002, female patients and physicians became apprehensive about HRT as they deemed it no longer safe to take Premarin and Provera.

As you can see, for female and male patients, there are genuine concerns by physicians that synthetic hormone drugs have been shown to increase the risk of cancer and cardiovascular disease. There is a push by the medical community to avoid the prolonged use of synthetic hormones. However, the predicament is aging patients may still benefit from youthful hormone levels. There is increasing evidence that bioidentical hormones can actually help protect the body against the conditions caused by synthetic hormones, which are foreign to the human body.

There are research findings indicating that men and women may safely benefit from personalized or individualized dosages of bioidentical hormones over their lifetime. Additionally, lifestyle changes, such as avoiding food sensitivities, assuring optimal vitamin D status and nutrient blood counts, may prevent and even reverse the damage to various cells in the body.

When should I begin bioidentical hormones?

Hormones starts decreasing once a person enters their 30’s. As such, bioidentical hormone replacement therapy can commence anywhere from ages 35 to 55 after the appropriate tests have been completed.

What hormones are important to be tested when you visit a Naturopathic Physician?

There are many hormones tested by a Naturopathic Physician during a routine screening.

They include:

Cortisol

Cortisol is produced by the adrenal gland and plays an important role in helping the body deal with stress. It should be higher in the morning and lower at night; it helps you wake up in the morning and go to sleep at night. It contributes to your circadian rhythm. When cortisol levels are low, it is termed “adrenal fatigue”. If cortisol levels are high, it contributes to anxiety and insomnia.

DHEA (Dehydroepiandrosterone)

DHEA is a precursor to some of the sex hormones, and is important for the formation of these hormones. It is produced by the adrenal glands and decreases as we age. Low levels of DHEA can lead to premature aging and increased incidence of chronic disease. As such, it is considered the “anti-aging” hormone. When DHEA is stimulated to be produced in the body, the immune system is stimulated and the patient feels an overall sense of wellbeing.

Estrogen

Estrogen is secreted by the ovaries and adrenal glands. When estrogen levels are low, women experience menopausal symptoms, such as hot flashes, mood swings and insomnia. When you replace low levels of estrogen with natural estrogen, there is a protective effect against heart disease, Alzheimer’s disease, osteoporosis among other conditions.

Growth Hormone

Human growth hormone, produced by the pituitary gland in the brain, is important in all cells for growth, reproduction and tissue repair. Studies show that stimulating the production of growth hormone can work as an anti-aging agent, and can help decrease body fat while increasing muscle mass.

Melatonin

Melatonin helps with sleep. It is produced by the pineal gland, and is important in regulating the circadian rhythm. Melatonin levels naturally decline as we age, and melatonin has been studied to help improve sleep but also works as a strong antioxidant in particular cancer treatments.

Prenenalone

Pregnenalone declines after the age of 30, but is a precursor to many other hormones in the body. It plays a role in improving cognition, learning, mood and memory, as well as stimulating deep sleep and the immune system.

Progesterone

Progesterone is secreted by the ovaries and adrenal glands. Studies show that natural progesterone reduces the symptoms of menopause and has a protective effect against certain breast and endometrial cancers. It is a natural antidepressant and promotes bone building while protecting against osteoporosis

Testosterone

Testosterone is produced by the testes in men and adrenal glands both men and women. It is best known as a male hormone to help with virility, fertility and body building, but it also is present in female patients and plays a role in women’s health and well being. Testosterone production naturally declines after the age of 30

Thyroid Hormone

Thyroid hormone production also declines with age. Low thyroid hormone levels can cause fatigue, hair loss, weight gain, constipation, cold hands and feet, as well as dry skin and brittle nails.

Regardless of which hormones are deficient in your body, a Naturopathic Physician, with the aid of the appropriate hormone tests, can help determine which hormones you need, and in what doses.

Dietary Approaches to Balancing Your Hormones

By Dr. Joanna Rosenfeld

1. Include Healthy Fats

Fat and cholesterol provide the precursors to our sex hormones. Ensuring you get enough healthy fats in your diet is critical to hormone balance. Healthy fats help to decrease inflammation in the body, help to maintain a healthy body weight and

Healthy Fats: Olive oil, coconut oil, avocados, fish, nuts and seeds

How to do it:

  • Include 2tbsp of ground flax seed in your diet each day – you can sprinkle it on top of oatmeal, or in a smoothie. Flax seeds provide a good source of anti-inflammatory fats, aid with digestion and also help to balance estrogen levels in the body.
  • Cook with coconut oil – it has a high melting point and provides a good source of medium chain triglycerides – important for brain health and development as well as weight loss.
  • Drizzle olive oil over roasted vegetables and salads.
  • Try to consume fish 2-3 times per week. Smaller fish will accumulate less mercury, for example: anchovies, butterfish, catfish, clam, crab (domestic), crawfish/crayfish, croaker (Atlantic), flounder, haddock (Atlantic), herring, mackerel, oyster, perch (ocean), salmon (fresh, canned), sardines, scallop, shrimp, sole (Pacific), squid (Calamari), tilapia, trout (freshwater), whitefish
  • Use nuts and seeds as a snack. Chia seeds can be made into a pudding and eaten as a nice breakfast, or snack. Homemade trail mix with a mixture of walnuts, almonds, brazil nuts and cashews are a good mid-day snack to be eaten in moderation.

 

2.  Increase your Veg!

Eat all the colours of the rainbow to ensure you are getting the phytonutrients your body needs. Aim for 1 cup of each colour every day: blue, red, green, yellow/orange and white.

The cruciferous vegetables are especially beneficial for helping with estrogen balance and detoxification. These include broccoli, brussels sprouts, cabbage, cauliflower, collard greens, kale, kohlrabi, mustard, rutabaga, turnips, bok choy, and chinese cabbage. Arugula, horse radish, radish, wasabi, and watercress are also cruciferous vegetables.

Eating more colourful vegetables also helps to maintain a healthy weight. Being overweight can increase estrogen dominance in the body, and disrupt hormonal balance. Veggies also pack a hefty punch of dietary fiber, which helps maintain regularity, and also ensures that excess estrogens are being excreted.

How to do it:

  • Make ½ your plate veggies – lightly steaming or cooking your vegetables makes them more digestible.
  • If you enjoy a morning smoothie, fill up your blender with a mixture of vegetables: leafy greens, avocado, celery, beets and more.
  • When you make pasta sauces or stir fries, make the bulk of the sauce from vegetables, with some additional protein and fats.

3. Pack on the Protein

Proteins form the building blocks of our cells, and are important for creating hormones, maintaining a healthy immune system, achieving an ideal body composition and much more. Proteins (especially when combined with healthy fats and fiber) help to balance our blood sugar levels, which can be extremely important for reproductive health and ovulation.

How to do it:

  • Choose organic meat when possible to decrease the amount of exogenous hormones in our food.  Ensure a palm-sized amount of protein at all your meals.
  • Choose smaller fish (listed above), which contain fewer heavy metals and toxins.
  • When selecting red meat, opt for grass fed meat. The cuts from grass fed animals are less inflammatory and contain more healthy fats than traditional grain fed meats. These animals also generally come from more humane farms.
  • Choose free-run organic eggs to ensure you are getting the highest quality eggs from chickens that are not confined to small cages.
  • Vegetarian sources of protein are also a great choice, and high in additional fiber. Lentils, beans, peas and quinoa are some great options. If you find you have difficulty digesting beans or lentils, you can try soaking them overnight before eating to break down some of the hard to digest fibers. Rinsing quinoa thoroughly just before cooking will also help make it more digestible.

Foods to Avoid/Minimize:

1. Dairy

In addition to being a common allergen, dairy foods tend to upset our hormonal balance. Dairy has been associated with increased hormonal acne, more PMS and menstrual cramps and increased inflammation in the body.

2. Added Sugar

Sugar is the most inflammatory substance we can consume. It disrupts our blood sugar balance and contributes to systemic inflammation. This can wreak havoc on your menstrual cycle, mood, energy levels and immune system. Sugars are addictive, unfortunately. The more we have, the more we want. So keep your sweets to a minimum, and enjoy fresh fruit to satisfy your sweet cravings.

3. Caffeine

Caffeine can place an extra burden on the liver’s detoxification process and interfere with Caffeine should be limited to no more than 200mg in pregnancy – this is the equivalent of a “short” drip coffee from Starbucks. Better yet, switch to decaffeinated coffee or green tea, or herbal teas to help with energy levels, mood and hormone balance.

4. Alcohol

Alcoholic drinks can pack on the pounds and disturb your sleep, contributing to hormonal imbalance. Alcohol also places additional stress on the liver, making it work harder to process and break down hormones. Keep alcoholic drinks to 1/day for women, and none during pregnancy.

5. Processed Foods

Processed foods are high in sugar and simple carbohydrates, leading to blood sugar imbalances, digestive disturbances and weight gain. Processed foods are often high in sodium, contributing to high blood pressure and water retention.