DR. BOYER B. COLE
Naturopathic Medical Doctor
(415) 721-7453
25 San Anselmo Avenue, San Anselmo, CA 94960
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Bio-Identical Hormone Therapy
Saliva Hormone Testing vs. Blood Testing
In the past 20-30 years research studies have validated saliva as a diagnostic medium to measure the free or "unbound" biologically-active portion of hormones in the bloodstream. These are the bio-available hormones, doing their job at the cellular level and the ones you want to know about when testing your hormone levels. Saliva hormones more accurately reflect absorption and tissue uptake of creams, gels or patches. Blood assays significantly underestimate hormones delivered topically, often resulting in overdosing. Blood tests measure the serum, yet do not measure tissue uptake at the cells in key organs such as the brain, uterus, skin and breasts.
Saliva testing is quicker, painless, and less expensive than blood tests. It is a reliable way to measure steroid hormone levels, and it will confirm that the hormones you are taking are being absorbed and utilized. Saliva hormone assay tests have been used for many years by the World Health Organization for world wide hormone testing.Urine Hormone Testing
Hormone levels can also be determined by urine testing which shows the metabolic pathways and conversion of hormones (how they break down). More hormones are assessed than in saliva tests, and this test has a broader perspective in the evaluation. A 24 hour urine collection reflects the total output of hormones in a day.Balancing Hormones For Men and Women
Our bodies struggle to keep our hormones in balance. The hormones in our meats and the chemicals in the environment mimic estrogens in our body. Our daily stress taxes our adrenal glands. Pollution and toxins weaken our thyroid gland. Poor digestion and elimination affect our metabolism of estrogen, while a diet deficient in nutrients decreases the production of all healthy hormones. Birth control pills add to the problem. On top of this, hormone levels can drop 1-2 % a year from the age of 30.
Thyroid hormone sets the metabolism of the cells, and low thyroid affects one's energy and the function of the entire body. High levels of estrogen will inhibit thyroid function. Also low levels of cortisol (from the adrenal glands) reduce the activity of thyroid hormones. Chloride, fluoride, and bromide (chemicals added to tap water, hot tubs, swimming pools, foods) actively compete with iodide in the thyroid gland for the production of T4 thyroid hormone, the main thyroid hormone. The thyroid gland is an integral part of all hormonal communication and needs to be assessed with any hormonal evaluation.
The complex interaction of a woman's hormones can be disturbed by all the above factors. Hormonal problems can first be seen with PMS during a woman's menstrual years. PMS is defined by the presence of symptoms before menstruation with the absence of symptoms after menstruation. Stress, unhealthy eating, toxins, and contraceptive use can disrupt ovulation and can contribute to infertility and even endometriosis. This usually can be corrected with proper diet, vitamin and mineral supplementation, herbs, detoxification and possibly bio-identical progesterone. Extreme symptoms during these years indicate hormone imbalance, a dominance of estrogen years before menopause.
At perimenopause, women begin to have irregular, shortened, or lengthened cycles often without ovulation. Progesterone is made after ovulation. This leads to a case of too much estrogen relative to progesterone. This ratio has been coined by John Lee, M.D. as "estrogen dominance". With the extreme drop in progesterone, estrogen becomes the dominant hormone even as estrogen declines, which leads to perimenopausal symptoms. Estrogen dominance can lead to symptoms of breast tenderness, depression, fibrocystic breasts, PMS, thyroid dysfunction (hypothyroid), irritability, infertility, autoimmune disorders and more. These can be managed with diet, nutrients, homeopathics, herbs, adrenal support and sometimes bio-identical hormones. Two very important causes of this hormonal imbalance are a lack of regular ovulation and depletion of the adrenal glands. This is worsened by meats that are pumped with estrogen; chemicals and pesticides that mimic estrogen in our body; unhealthy diets high in refined carbohydrates and sugars; vitamin and fatty acid deficiencies; and stress.
At menopause (12 consecutive months without a period), estrogen drops by approximately 40-60% and without ovulation progesterone output drops to nearly 0. The adrenals are the backup source of progesterone, which may not be available with adrenal stress. Overall, the drop in estrogen from the ovaries with little progesterone can bring on symptoms of hot flashes and night sweats, forgetfulness and foggy thinking, weight gain, and low libido.
IN MEN hormone levels also drop, but more gradually than women. As a result, men may not recognize the loss of hormones. Andropause, the decrease in men's hormones, often occurs between age 40 and 50 as the production of testosterone starts to decline, leading to decreased virility, stamina and drive. Often by age 50 men's testosterone and DHEA levels are 20-40% below youthful levels. Obese men have even lower levels of these hormones. Alcohol will also adversely affect hormone balance. Some signs of low testosterone include thinning hair, decreased libido, increased abdominal fat, declining muscle mass, night sweats, and also depression. With age, testosterone levels decline and at the same time estrogen can rise. This hormone shift will block testosterone, increase abdominal fat, and adversely affect the prostate gland.
The shifting hormones for women during perimenopause and menopause and andropause in men may call for bio-identical hormone replacement. This therapy provides hormones just like your body makes and in the same amount your body would expect to have in the cells. Bio-identical means the hormones are synthesized from wild yam and soy and are identical in structure and function to those our body produced before menopause or andropause. With women, progesterone is the natural bio-identical form of the hormone as opposed to progestin, the synthetic version. Estrogen is also made identical to the body's hormones verses synthetic premarin, which is from a pregnant mare's urine and contains equine hormones! There are many other synthetic forms of hormones on the market which are not bio-identical.
Unopposed estrogen, meaning estrogen taken without progesterone, can create estrogen dominance in the tissue putting a woman at a higher risk for breast cancer and reproductive disorders. Estrogen should always be used in combination with progesterone, yet progesterone may be used alone without estrogen. Stress management and detoxification programs can also optimize hormone function. -
Note the complexity and significance of proper hormone function and balance:- Estrogen dominance suppresses the thyroid.
- Fibrocystic disease is an estrogen dominance problem and iodine deficiency.
- Tender breasts are a sign of excess estrogen and poor detoxification.
- Excess estrogen uses up B6 and decreases magnesium.
- High cortisol will down regulate thyroid receptors on the cells.
- Hot flashes and night sweats in women are often corrected by balancing progesterone and estrogen.
- Men with low testosterone are at high risk for heart disease and benign prostatic hypertrophy (BPH).
- Fatigue, irritability, low libido, erection problems, muscle loss, and night sweats can be a sign of low testosterone in men.
- Depression is often associated with low testosterone in men, low estrogen in women, and low thyroid in both men and women.
- Tearfulness and foggy thinking can be from low estrogen levels.
- Low DHEA can be associated with depression.
- Chronic adrenal stress can lower DHEA levels.
- Low adrenal function can cause fatigue, allergies, chemical sensitivity, sugar craving, and low body temperature.
- Progesterone will improve thyroid function.
- Progesterone applied at night can help with sleep.
- Vaginal dryness is a sign of low estrogen. Vaginal thinning is a sign of testosterone deficiency.
- After menopause the outer lining of the ovaries produces testosterone.
- As hormone levels decrease, so does the quality of a woman's skin.
- Many hormone levels peak in our early 20's and decline significantly as we grow older.
- The liver is responsible for the creation and breakdown of hormones. The intestines eliminate unwanted bound hormones.
Copyright © Boyer B. Cole, ND. All rights reserved.