“The resurgence of bio identical hormones parallels the advances in space travel. Knowledge, Empowerment and Implementation”

What are Hormones?
• The secretion of an endocrine gland that is transmitted by the blood to the tissue on which it has a specific effect
• Chemicals made in the body, act at distant sites from where they are made, and help regulate body functions including immunity, metabolism, growth and reproduction

What are Bio-identical Hormones
• Bio-identical hormones are natural (usually plant-based) hormone substances that are nearly identical in structure and chemical composition to the hormones your body produces on its own.
• The interest in a more natural approach to hormone therapy has focused attention on bioidentical hormones — hormones that are identical in molecular structure to the hormones women or men make in their bodies

Balance Hormone & replacement Therapy
• *All hormones restored to 25-30 year old level and monitored by regular serum levels.
• Natural (biologically identical) hormones
– Identical molecular structure to hormones produced by human female or male
– Not xeno hormones or horse hormones (Xeno hormones are pollutants originating outside the body that have hormone-like and estrogen-like activities.)
– Extracted from plants (like soy)
– DNA recombinant synthesis

What are the goals? Both Treating & Prevention
• *Coronary heart disease
• *Cancer
• *Dementia
• *Alzheimer’s
• *Insulin resistance (type II diabetes)
• *Degenerative body composition
• *Osteoporosis
• *Immune system decline
• *Loss of libido and sexual function
• *Menopause symptoms
• *Hair loss
• *Obesity
• *Fatigue/loss of memory/depression/inability to concentrate
• *Increased resistance to infections
• *Rapid healing of injuries
• *A feeling of well being

“Let’s consider the Prevention of Cancer and disease before we address the Cure”

Most common hormones
• Growth hormone
• DHEA (Dihydroepiandosterone)
• Testosterone
• Estrogen
• Progesterone
• Thyroid
• Melatonin
• Insulin

Symptoms of Low Growth Hormone
• Osteopenia (brittle bones=fractures)
• Sarcopenia (loss of muscle mass)
• Loss of exercise capacity
• Increased total and intra-abdominal fat
• Intolerance to glucose (sugar)
• Dyslipidemia (lipids are abnormal)
• Increased fragility of skin & blood vessels
• Decreased quality of life

Symptoms of low DHEA
• Depression
• Less muscle and bone mass
• Pain in the joints
• Lower sex drive
• Less hair in underarms
• Dry skin and eyes
• Poor memory
• Difficulty in losing weight
• Low levels of Dhea in the body has also been associated with a weakened immune system

Symptoms of Low Testosterone
• Increase in fat mass
• Decrease in muscle mass
• Forgetfulness
• Loss of memory
• Poor concentration
• Insomnia
• Decrease in well being
• Decrease in Libido

Symptoms of Low Estrogen
• Hot flashes
• Dry Skin
• Urogenital atrophy
• Sleep disturbances
• Sexual dysfunction
• Colorectal cancer
• Glaucoma & cataracts
• Macular degeneration
• Memory and cognition decline

Protective Benefits of Estrogen
• *Decrease LDL
• *Increase HDL
• *Protection of CAD & atherosclerosis
• *Prevention of Alzheimer’s Disease (79%)
• *Prevents formation of amyloid – B protein
• *Prevention of depression & mood disorders
• *Tooth loss & gingival atrophy
• *Osteoporosis

Symptoms of low Progesterone
• Premenstrual Syndrome (PMS)
– Katherine Dalton: “PMS & Progesterone Therapy”
– 30,000 women
– Treated up to 2400mg.day
– Offspring of those on Progesteron excelled.
– Premenstrual tension
– Bloating and weight gain
– Depression
– Mood swings
– You don’t need a progesterone level, Rx SX

Symptoms of low Progesterone
• Anxiety
• Headaches
• Frequent miscarriages
• Infertility
• Heavy Menstrual flows

Conditions associated with low progesterone
• Infertility
• Frequent abortions
• Premature Labor
• Post Partum Depression
• Child intelligence
• Estrogen dominance issues
• Breast Cancer
• Uterine Cancer
• Elevated LDL and decreased HDL
• Decreased Libido
• Weight gain

Benefits of Progesterone
• *Lowers LDL, raises HDL
• *Protects against uterine cancer
• *Treats PMS
• *Reverses bloating, weight gain, depression
• *Feeling of well being
• *Supports pregnancy
• Synergistic with estrogen
• *Decreases the risk of breast cancer, colon cancer and rectal cancer
• *Prevents coronary artery constriction
• *Enhances protection of estrogen for osteoporosis
• *Improves female sexual response

Overwhelming Evidence of the Estrogen Therapy & Cancer
• WHI study flawed beginning Rx at age 60-62 where CAD already present
• PremPro was used rather than natural Estrogen & Progesterone
• Incidence of breast CA on HRT was: RR-1.26 while on ERT was RR-0.57
• Adding a progestin to estrogen > risk of breast CA by 29%
• Growth inhibited by progesterone by increasing P13-kinase/AKT killing the cancer cells (Er J. Cancer Pre 2002 Oct: 11 (5);481-8
• MPA stimulates proliferation of breast cancer cells: Progesterone does the opposite with or without estrogen
• Progestins > risk of breast CA 8 times over baseline Estrogen and Osteoporosis
• WHI underestimated importance of hip Fractures
• 50% 2-year mortality over age 75 with osteo
• 3 times more osteoporotic Fractures than heart attacks.
• 6 times more osteoporotic fractures than strokes
• 8 times more osteoporotic fractures than breast CA

Estrogen and CAD
• *Estrogen alone reduces risk of primary CAD: adding Progestin > risk of CAD & strokes; Annuals of Int. Med 2000: 133:933-941
• Progesterone synergistic with estrogen and >HDL,
• *OMP HDL, no side effects, no endometrial hyperplasia: Obstet Gyn 1989; 73: 606-611
• Conclusion: Natural E2 and OMP offer great benefits & should be the agents of choice for menopause.

Symptoms of Low Thyroid
• Fatigue
• Depression
• Weight gain
• Dry skin
• Brittle nails
• Thin hair
• Intolerance to cold
• Memory and concentration issues
• Constipation
• Hyperlipidemia: often see increase cholesterol and LDL
• Fibromyalgia symptoms

Symptoms & Signs of Melatonin Deficiency
• Insomnia
• Difficulty getting to sleep
• Difficulty falling back to sleep when awake during the night
• Light sleeper/easy waking during the night
• Early morning awakening
• Un-refreshing sleep

Symptoms & Signs of Melatonin Deficiency
• Lack of dreaming
• Family history of insomnia
• Personal or family history of breast cancer
• Personal or family history of prostate cancer
• Prostate enlargement
• Fatigue
• Depression

Associated conditions sometime seen with Melatonin Deficiency
• Irregular menstrual cycle
• Unusual menstrual flow (light or heavy)
• Scoliosis
• Poor sleeping prior to menses
• Anxiety
• Sensitivity to stress
• Cataracts

Associated conditions sometimes seen with Melatonin Deficiency
• Neurodegerative disorder (MS, Parkinson’s, Alzheimer’s, ALS)
• Elevated cholesterol
• High blood pressure
• Blood clots
• Heart attack
• Heart arrhythmias

Insulin Problems
• Insulin resistance responsible for PCOS and Type II diabetes
• Contributes to the “Syndrome X” metabolic syndrome
– Increase insulin levels due to resistance >15
– Abdominal obesity
– Increase in triglycerides > 150
– HDL down
– Increase in blood pressure
– Type II diabetes
• Polycystic Ovary Syndrome (PCOS)
– Defect not in ovary but insulin resistance and/or insensivity
– Enlarged ovaries, anovulation
– Acne
– Hirsutism (increase in testosterone, conversion from other steroids)
– Male pattern baldness
– Obesity
– Lipid Abnormalities
– Glucose intolerance
– Insulin resistance will increase IGF-1 (insulin-like growth factor) which will increase weight and estrogen Diagnosis and Treatment
• Diagnosis of all hormone issues based on laboratory findings and clinical symptoms
• Many times treatment will result in higher than the normal laboratory levels
• Laboratory studies repeated after 6 to 8 weeks and symptoms reevaluated.
• Patients can have deficiencies in one or all the hormones.
• Treatment is customized according to the laboratory findings and symptoms.


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