Seasons Wellness Clinic » DHEA

The Top 3 Answers to the Question “Why Should I Take Hormones?”

Dr. Nathan Goodyear — Fri, 06 Apr 2012 16:59:21 +0000

Dr. Nathan Goodyear, Overseeing Physician at Seasons Wellness Clinic

Recently during a patient’s visit, we were reviewing her most recent OB/GYN appointment. Her physician asked why she was taking hormones. Unable to offer a technical explanation, she simply stated that she felt much better than she did before she began her treatment program.

While the basic question of WHY is a good question by her physician, we actually need to answer three questions.

What are my individual hormone levels?
Are my hormones in appropriate balance?
Is my body metabolizing those hormones in the right way?

The answers to these three questions will answer the one question: “Why should a patient take hormones?”

What are my individual hormone levels?

Contrary to what most think, hormones are not just about individual numbers. Instead, hormones work collectively as a means of communication within the body. I am amazed at the answers I get when I ask postmenopausal women, “Does your body still have or need hormones?”

The answer is a resounding YES, but most people seem to think otherwise. The body must have hormones to survive. For example, those who suffer from Addison’s Disease have a life-threatening deficiency of cortisol (one of the body’s many hormones).

Far too often I hear the comment, “I’ve had a hysterectomy, so I don’t need progesterone.” The truth is having a hysterectomy does not eliminate your body’s use or need for hormones. It just means you are missing your uterus. Hysterectomy or not, millions of cells throughout the body have progesterone receptors and those cells could care less if you’ve had a hysterectomy or what your OB/GYN thinks about progesterone. [Insert laugh here!] These organ systems throughout the body have receptors for progesterone because they need progesterone.

The aforementioned patient’s hormone therapy included progesterone cream and DHEA capsules. Testing results showed her to be deficient in both progesterone and DHEA (read about how we test hormones at Seasons), and thus replacement was needed. In addition to test results, the patient’s clinical symptom history warranted the replacement of these hormones.

So why was DHEA included in her treatment program? Two reasons. The first is that her DHEA levels were low in her testing results. The second reason? This patient had Type II Diabetes and, after some additional testing, was found to have chronic inflammation throughout her body. DHEA has been shown to reduce inflammation, improve insulin function, and reduce obesity, all of which are associated with diabetes. DHEA does this through a complex interaction with the hormones adiponectin and insulin. As insulin levels rise with insulin resistance, adiponectin falls. This hormone imbalance will result in Diabetes for many people.

Additionally, Type II Diabetes has been shown to be the result of chronic inflammation. What does that mean, you ask? Chronic, dysregulated inflammation causes insulin resistance. What is the source of this inflammation, you ask? Fat cells! The obesity epidemic is the root cause of our current healthcare crisis.

Let’s go back to the patient’s hormone therapy. Her test results showed her deficient in progesterone. Because progesterone is a natural anti-inflammatory, it is currently being used in traumatic brain injuries (TBI) to reduce inflammation and improve outcomes. In addition, women with low progesterone tend to have significantly more menstrual cramps, the result of inflammatory signals called prostaglandins. Progesterone therapy has been shown to reduce those prostaglandins and thus reduce menstrual cramps.

Are my hormones in appropriate balance?

Hormones don’t exist in a vacuum, as many seem to think. Hormones exist in a delicate balance. The most well publicized imbalance is that of the estrogens and progesterone. Imbalance of estrogen and progesterone have been linked to many health problems: fatigue, weight gain, headaches, and increased risk of breast cancer to name a few.

I often tell patients that with every cause there is an effect. You can’t give one hormone without affecting many others. The addition of progesterone to the body when it has been chronically low will not only restore progesterone to an appropriate physiologic level, but will also allow estrogen signals to work better. The balance of hormones allows each hormone to work as it was intended. Mind you, we are NOT talking about using synthetic hormones which are simply not what the body is looking for and contain harmful additives. We only treat with bioidentical hormones (bioidentical hormone replacement therapy, also known as BHRT).

Is my body metabolizing my hormones in the right way?

The final key point is looking at how the body processes hormones (metabolism). Hormone metabolism is just as important as the individual hormone levels and the hormone balance.

Let’s use estrogen metabolism, for example. Estrogens (there are actually three different types of estrogen) can be metabolized three ways: 2-hydroxy estrone, 4-hyroxy estrone, and 16-alpha-hydroxy estrone. Some of the risks associated with estrogen come from the body metabolizing estrogen utilizing the 4-hydoxy estrone pathway. This pathway results in many dangerous metabolites (break down products). Think of it as turning down the wrong road as you’re driving somewhere, and you end up in a briar patch!

Think about it. Many women with breast cancer and men with prostate cancer don’t take bioidentical estrogen nor do they take synthetic estrogen. Their problem, as it relates to hormones, comes from endogenous hormone production (the body’s own hormone overproduction or underproduction), hormone metabolization, and the often undiscussed environmental xenoestrogens (from environmental toxin exposure). In lay terms, the body is metabolizing estrogen using the 4-hydoxy estrone pathway resulting in higher risk of cancer.

It has only been in the last 50 to 60 years that major hormonal imbalances in industrialized countries seem to have come to our attention. Before that, people and their hormones seemed to do just fine for thousands of years. We can attribute much of that to diminishing nutritional value in our foods and continually increasing exposure to toxins. Nutrition and toxins both have profound effects on the body, hormones included.

In conclusion, why should a patient take hormones (BHRT)?

The answer is a summary of the three points we’ve looked at here. By determining current hormone levels, restoring balance, and evaluating the body’s metabolic processes, the body can once again function as God intended it. Should a patient be on hormones? Well, only if you need them. But the truth is few of us have perfectly balanced hormones due to nutrition, toxin exposure, and prescription medication side effects.

At Seasons Wellness Clinic, we use state-of-the-art testing that reveals your body’s biochemistry. With our years of advanced training, we can carefully customize a treatment plan to restore your body, offsetting the damage of poor nutrition, toxins, and prescription drugs. Our goal is to eliminate any need for prescription medication! We want you to be HEALTHY!

WELLNESS IS POSSIBLE! You don’t have to settle for a body that is not working as it should. You can make a conscientious choice towards good health and a longer, happier life.

From The Doctor’s Desk: The Moral of the Story? Hormone Balance Key To Reducing Breast Cancer Potential.

Dr. Nathan Goodyear — Thu, 12 Nov 2009 19:09:50 +0000

Dr. Nathan Goodyear

I have four kids that range in age from four to eleven. One of my favorite things to do is read them a great story. So today, let’s talk about some very important stories and the moral each one presents.

The story about breast cancer potential has more characters than just estrogen and progesterone as we discussed in my last post. There are other hormones that are integral characters in that story also. As you will learn in this post, the moral to the breast cancer story is balance — balance between all the hormones in your body.

The Story On Dehydroepiandrosterone (DHEA) — Say That One Three Times Fast!

DHEA, a testosterone precursor, is a hormone produced by the adrenal glands and plays a part in breast protection. DHEA plays an important role in supporting the immune system. DHEA stimulates the production of good T-helper lymphocytes-1 and their associated good cytokines: interferon, Interleukin-2 and Tumor Necrosis Factor-beta. This is in contrast to the bad T-helper lymphocytes-2 and their bad cytokines. DHEA levels typically decline as we age. The decrease in DHEA levels are inversely correlated with increasing age-related disease. The strength of this correlation is yet to be determined, but the decline in immune system due to low DHEA is clear. So where does that leave DHEA? Individuals with low DHEA levels have more disease, and in this case, more breast cancer. The moral of this story? Low DHEA = a compromised immune system = breast cancer vulnerability.

The Story On Melatonin — The Sandman Hormone.

Melatonin is the hormone that regulates your sleep cycle. It is produced from the pineal gland in the brain. Low melatonin levels have been linked to breast cancer through the additional benefits of melatonin. Melatonin boosts the immune system, decreases estrogen and progesterone production, and acts as an anti-oxidant. Bench studies (non-human studies) have shown significant increase risks of breast cancer with low melatonin levels. Can you guess what happens as we age? Yes, you guessed it. Our melatonin levels fall. Ever talk to a post-menopausal woman? Most women of that age have sleep-related complaints. The moral of this story? Low melatonin = a compromised immune system = breast cancer vulnerability.

The Story on Thyroid — The Energy Hormone.

How about the thyroid hormone? The breast cancer link reaches to all hormones and everything seems to involve the thyroid these days! T4 (or better known as synthroid, levoxy, levothryoixine) is one of the most prescribed medicines today. But T4 is a very weak thyroid hormone. In fact, the body is looking for T3, a result of T4 to T3 conversion. The problem is that many individuals don’t convert T4 to T3 well. (Very often I see patients who have been on synthroid for years without symptomatic improvement even though their “levels” are said to be “good”. I digress. That’s a subject for another post. Let’s get back to the breast cancer link.) Low T4 and T3 levels result in low sex hormone binding globulin levels (SHBG). SHBG is how some hormones are transported. When SHBG levels drop, the free availability of the hormone it transports goes up. In this case, the levels of free estradiol go up. Remember the negative breast implications of estrogen dominance from last weeks post (link)? The moral of this story? Low thyroid = low SHBG = high estradiol = estrogen dominance = breast cancer vulnerability.

The Story On Insulin — The Sugar Storer

Finally, Insulin. Insulin’s primary role is in the storage of glucose. However, due to the large percentage of simple or refined sugars in our diet, insulin resistance has become a major epidemic, and, yes, insulin resistance increases the risk of breast cancer. How, you ask? High simple sugars leads to insulin resistance and PCOS (Polycystic Ovarian Syndrome). As a result, estrogen dominance and excess testosterone are produced which leads to weight gain. Remember that fat cells produce even more estrogen and estrogen stimulates breast cell growth (link). Young women will start their cycles at an earlier age and thus will increase their lifetime exposure to estrogen without appropriate progesterone balance. And to make matters worse, traditional therapy with birth control pills for these young women increases the breast cancer risk even further. The moral of this story? Insulin resistance = estrogen dominance = breast cancer vulnerability.

Change The Ending Of The Story.

Just because any of these hormone deficiencies might produce in you symptoms which you recognize in this post doesn’t mean that you are going to have breast cancer. However, the sooner you seek hormone balance, the quicker you are going to lower your breast cancer vulnerability/potential. As you can see, the hormonal symphony is what is important. Balance! When your hormones are balanced, the result is a symphony, and in turn, your body is in tune and makes beautiful music. But when your hormones are not balanced, then…well, you know the ending of that story.

Hormone Symphony

Dr. Nathan Goodyear — Fri, 12 Dec 2008 13:35:24 +0000

Have you ever heard a great symphony play under a great conductor in a great symphony hall? I have. The music is beautiful.

Of course, it doesn’t matter how good the conductor is or how good the acoustics are—if the orchestra is not good. If the symphony’s tempo is off, or the pitch, or the key, or the volume, then it doesn’t even matter who wrote the music. Beethoven, Mozart, or Bach will just sound like noise to the audience.

Symphony comes from a Greek word meaning “agreement or concord of sound.”

Your hormones are like a symphony. When everything works together, then and only then can you appreciate the beauty of the music.

When your hormones are out of balance, your body will experience symptoms that wreck the music—hot flashes, mood swings, weight gain. Like a symphony, your hormonal balance is more complicated than any individual part. It is not just about your estrogen and thyroid as many would have you believe. Your hormonal symphony requires the balance of all hormones: all estrogen types, progesterone, testosterone, DHEA, cortisol, thyroid, and melatonin. One hormone out of balance can start a ripple effect that results in total hormonal imbalance.

When your hormones are not balanced, your body feels like a bad symphony, just making noise. However, when all hormones are balanced, your body can make beautiful music. If we reduce your diagnosis to estrogen problems or thyroid problems only, we will miss the mark. When we evaluate and treat your hormones as a whole system, your body can be a symphony.