Hormonal Health: A new approach in Integrative Medicine

Paul Reller, L.Ac.

The key to hormonal health may be found in the fast development of the science of natural bio-identical hormones. Synthetic hormone replacement in menopausal health and use of synthetic hormones in control of inflammatory processes and asthma, auto-immune disorders, and other problems has garnered much bad press because of the proven risk, harm and side effects involved. Only now, after decades of use has some of the long range consequences become apparent. Two large studies by the Women's Heatlh Initiative has led to an NIH (National Institutes of Health) conclusion that synthetic hormone replacement dramatically increases risk of breast cancer, cardiovascular disease, deep vein thromboses and other serious threats to your health.

In 2010, standard medicine once again attempted to bring back some semblance of respect for their long history of prescribing dangerous and problematic synthetic hormones despite much evidence of potential harm, especially with risk of cancers and cardiovascular disease, and dramatic signs and symptom complaints from patients, by stating that evidence does show that unopposed estrogen does appear to reduce the risk of breast cancer to some degree. Once again, confusing public statements about a subject too complicated for most patients to fully understand, were widely printed in the hope of restoring some public trust to medical doctors that recklessly overprescribed synthetic hormones for decades, with evidence that this medical practice was directly linked to a large increase in the incidence of breast cancer, uterine cancer, ovarian cancer and cardiovascular disease. Unopposed synthetic estrogen, or estradiol sulfate, was originally prescribed in these hormone therapies, quickly creating alarming incidence of serious health problems, and then always coupled with synthetic progesterone, or progestins, to reduce risks and harm. Today, though, we now see that balancing hormones to a physiologicall normal state, with simple testing and use of bioidentical plant hormones in topical creams, combined with herbal and nutrient medicine, and acupuncture, will achieve this reduction of risk of breast cancer without harm, and with very little risk of side effects.

The use of bioidentical estriol creams to stimulate increased estrogen production, balanced with progesterone stimulating bioidentical creams, with testing to analyze the actual restoration of hormonal levels to a physiological normal level that is individualized and adjusted for menstruating, premenopausal, perimenopausal, menopausal, and post-menopausal states, is a very effective approach, especially when combined with a protocol that features selenium supplementation, restoration of iodine levels in tissues, correction of subclinical hypothyroid states, periodic supplementation with DIM and potent lignans, and herbs that are proven in clinical trials to reduce risk of breast cancers. This type of therapy is available to patients that take advantage of a knowledgeable Complementary Medicine physician, such as a Licensed Acupuncturist and herbalist, as well as active hormone metabolite testing and analysis with simple saliva and veinous blood stick samples. The public is beginning to understand that the dire warnings against biodidential phytohormonal therapies that we were given by standard medicine, without sound scientific evidence of harm, was merely a ploy to protect the profits generated from the overprescription of synthetic hormones.

In fact, today, modern medicine, or standard medicine, is finally embracing these herbal extracts to provide a bio-identical hormone therapy as well, and combining this with a holistic approach with other supporting herbs and nutrient supplements. The public is applauding these progressive MDs that have acknowledged and embraced this modern integrative approach, combining safe and effective evidence-based Complementary Medicine with standard pharmaceutical practice. A combination of bio-identical hormones, herbal formulas, nutrient supplements and acupuncture utilizes the latest research with the proven effects of centuries of Traditional Chinese Medicine. An integrative approach may utilize both the progressive M.D. and the TCM physician, or Licensed Acupuncturist, and careful monitoring of your active hormone levels with laboratory analysis may be accomplished at either office. Considering the lack of medical school training in these herbal and nutrient therapies for medical doctors, and their long history of stubborn persistence of overprescription of synthetic hormones, though, many intelligent patients are insisting on integrating a real Complementary Medicine physician, or Licensed Acupuncturist or Naturopathic Doctor into their treatment team.

In recent years, much research has also linked the hormone called Vitamin D to a wide variety of health problems as well. Vitamin D was among the first chemicals in the body that was called a vitamin, or a naturally produced or essential dietary chemical that was important to maintain vitality. We have long ago learned, though, that Vitamin D is not really a vitamin, but a hormone, and that the daily metabolism of a sequence of chemicals is what is vital to our health. While some metabolites of these hormones may act as vitamins in the body, the actual chemicals of importance are tightly regulated, stored, and converted to provide a necessary hormonal regulation that is now recognized as important for almost all cells in the body. The sequence of lipid-based hormonal chemicals in D3 production are cholesterol, cholecalciferol, calcidiol, and calcitriol, and a healthy visceral function of the liver and kidney/adrenal organs is also vital to this hormone metabolism. The time to quit calling these chemicals vitamins is now, and attention to this important hormonal, or endocrine, balance in the body should be recognized by the public, especially the aging public. By continuing to call these chemicals vitamins, the public is encouraged to purchase and consume so-called vitamin D without adhering to the actual body's needs, creating a new potential for adverse effects that may be as bad as deficiency of the production of the chemicals. Professional guidance and testing to restore this essential hormonal metabolism has very much potential for increased health, quality of life, and reduced risk of the most serious consequences of aging and disease. Once again, the Complementary Medicine physician, such as the knowledgeable Licensed Acupuncturist and herbalist, or the Naturopathic Doctor, can help achieve this hormonal restoration in the best possible manner.

To learn more about these subjects, a number of informative articles are also available on this website, fully exploring the true story of so-called Vitamin D, clinical and subclinical Hypothyroidism and Hyperparathyroidism, hormone replacement and contraception, hormonal pathologies, calcium supplementation and its risks and potential harm, autoimmune disorders, and diabetes/metabolic syndrome. The informed and pro-active patient takes seriously their role in the modern integrated team of physicians and guides the therapies. A physician is defined in Stedman's medical dictionary with various meanings, including “a person who has been educated, trained, and licensed to practice the art and science of medicine”, such as a Licensed Acupuncturist, and “a practitioner of medicine, as contrasted to a surgeon”. The most important “physician” in the team is potentially the patient. A patient-centered approach to medicine works best when the patient becomes educated to their health problems and assumes a role in treatment guidance. The only person that is able to treat 24/7 is the patient.

Patient Knowledge is the Key to a Pro-Active Approach

The hormonal system, or endocrine system, is a complex feedback mechanism responsible for regulation and coordination in the body. The proper function of this system is extremely important for the health of both the man and the woman.

The endocrine system is composed of the adrenals, thyroids, parathyroids, pancreas, gonads/ovaries, thymus, hypothalamus, pituitary, pineal, and other tissues of the nervous system, muscles, vessels, bone and fat. Key hormones regulate the menstrual cycle, fertility, blood sugar, mineral circulation, bone density, sexual function, inflammatory processes, mood, blood pressure, and much of our chemical metabolism and excretion. When hormone production becomes deficient or excessive, and circulating levels are abnormal, many systems in the body may become dysfunctional because of the feedback mechanisms of the endocrine system. Not only menopausal symptoms, but diabetes, prostrate problems, autoimmune disorders, thyroid problems, breast cancer, osteoporosis, and other common health problems result. Infertility, a growing problem in industrialized societies, is also now recognized a having an underlying cause related to hormonal imbalance in a large percentage of cases. Endometriosis, ovarian cysts, and uterine fibrods also are related to hormonal imbalance, and even neurological disorders, especially neurodegenerative disorders, are now known to have hormonal imbalance as a key aspect of the complex underlying pathophysiology. Cardiovascular risk is increased dramatically by hormonal imbalance as well, and strokes, heart attacks and veinous thromboses are the most prevalent cause of death in the aging population. Even arthritic joint degeneration is now linked to hormonal imbalance, as the normal repair and growth of cartilage is dependant on a hormone Vitamin D3 isomer. By maintaining a healthy endocrine system the risks of cardiovascular disease and cancer are dramatically decreased and overall quality of life is greatly improved.

Hormones act by stimulating target cells and the hormonal effects are determined almost entirely by the target cells, not the hormones themselves. For this reason, many hormones are very similar, and in fact, many hormones easily become other hormones when the body needs them. We now know that hormonal receptors are numerous on cells, with some targeted cells having more than 300 hormonal recptors on a single cell, and that often these receptors are also triggered by neurotransmitters and immune cytokines. In fact, many chemical in the body act as both neurotransmitters and hormones, depending on the type of cell receptors, and the surrounding mix of chemistry in local tissues. Adrenaline, or norepinephrine, is the prime example of this type of simple chemical that plays complex roles in the body, and adrenal health is now recognized as a very important part of our overall healthy hormonal and endocrine function. The endocrine system, or excretion of hormones from glands, is in fact guided by neurological stimulation in the adrenal-pituitary axis, with the intimate pituitary sister organ, the hypothalamus, provides this neurological control of the axis. Complete hormonal balance is thus necessary to achieve optimum hormonal health, as well as healthy neurological, immune, and cardiovascular health.

Why are natural bioidentical hormones, mostly produced from plant sources, better in many ways than synthetic hormone pharmaceuticals? Synthetic hormones that are similar to your natural hormones trigger key hormonal responses the same as natural hormones, but confuse the body in regards to overall response. They do not easily transform into other hormones when needed, and they do produce a false feedback response that signals the endocrine system to act as if certain hormonal levels are high, when actual production of natural hormone is low, thus triggering a cessation of natural hormone production in the body. While synthetic hormonal medicines do produce dramatic results, and have their important role in hormonal therapy when needed, their use in general has many drawbacks that are not seen with bioidentical hormone therapy, which is now proven to produce effective and immediate results itself. Coupled with less direct hormonal therapies, such as acupuncture, which stimulates normal physiological processes in the brain, as well as the hormonal organs, and herbal nutrient medicine in general, which research has shown also may play key roles in maintaing hormonal health in less direct, but no less effective ways, the holistic package of care provides the patient and team of integrated physicians with tools to restore physiological hormonal levels and functions. On the other hand, chronic dependance on synthetic hormones discourages normal hormonal production, which is guided by a complex feedback mechanism in the body.

Bioavailability of hormones in the body depends on the health of the whole system. There are two types of hormones, lipid based and amino acid based. Healthy cholesterols are the backbone of the lipid based, or steroid hormones, such as the estrogens. Insuring that the cholesterol metabolism, based in the liver function, is optimal, is one key to hormonal health. Amino acid metabolism is also a function of the liver, which is a second reason that optimal health of the liver is important in hormonal health. Intelligent use of herbal formulas, acupuncture, and amino acid supplements with key vitamins may be very important to optimum liver function and lipid balance and targeted hormonal therapy. Natural restorers of lipid metabolism and balance, such as Red Rice Yeast extracts, bitter melon extract, Syntriol palm and citrus extracts, pomegranate extract, niacin metabolites (B3 as inositol hexacotinate), Gugulipid, Gamma Oryzanol, and Beta Sitosterol, are very effective, as well as Chinese formulas, to include in the treatment protocol. While taking a variety of medicines is not desirable to the patient, the consideration of these therapies should include the fact that, unlike pharmaceuticals, these herbal and nutrient medicines do not need to be taken forever, and actually achieve restoration of the natural physiological processes in the body.

“The person that works to achieve hormonal health holistically now, rather than waits until serious problems develop, is able to live a much healthier and productive life and decrease the fear of cancer, stroke, alzheimers, arthritis, and other serious health problems.”

Males and females both produce the same hormones, although menstruating females produce many hormones with a great degree of variance due to the feedback demands of the menstrual cycle. Because of the huge spikes in estrogen and progesterone associated with the monthly menstrual cycle and pregnancy, the female physiology becomes much less reliant on the production of these hormones in the adrenals, kidneys, liver, and other localized cells of the brain, blood vessels and fat cells, until ovulation ceases at menopause, with a hysterectomy, or with anovulatory disorders. When these events occur, the body often needs to be stimulated to achieve proper production of hormones from these other tissue sources. Synthetic hormones used in hormone replacement therapy are not identical to the natural hormones in your body. Synthetic hormones may alleviate some symptoms, but actually work to decrease the ability of the body to naturally produce hormones by replacing rather than stimulating. This is counter to a healthy life.

Plants have a physiology that is similar to animals, and so they too produce hormones in a system for regulation and coordination of physiological function. These plant hormones are often surprisingly similar to the human hormones. Many herbs and a few animal medicinals contain hormones useful to the treatment of the human. The wild yam of Mexico was one of the first plants to be highly publicized as a source of hormone replacement. Simply ingesting the herb had little effect, but use of the extract as a topical cream had dramatic effects, leading doctors to believe that this herb contained estrogen. Since then we know that it actually has an effect on the progesterone levels, primarily. It is often referred to as a progesterone cream.

The truth is that wild yam does not contain human progesterone or estrogen. The plant hormones it does contain stimulate increased progesterone production in the adrenals in a manner that is believed to be associated with affecting hormone receptors. The use of this herbal cream does not directly affect the progesterone level, only the production of progesterone within a feedback system. When it is used in an intelligent manner there are absolutely no ill effects. When used in the wrong dose or at the wrong time of the cycle, it can cause abnormal menstrual bleeding. This has frightened many women and practitioners. When used properly, especially when coordinated with other herbal formulas and acupuncture, and when hormonal levels are monitored with active hormone tests, it becomes a very safe and effective stimulation of proper hormone production. Increased estrogen production will result from increased progesterone production eventually, as will increased testosterone production, until proper levels are achieved, in a feedback system.

To facilitate a faster and smoother return to normal hormone production we also may make use of a topical cream with plant estriol. Estriol is in the estrogen family and use will stimulate increased production of the other, more active estrogens, estradiol and estrone. Estriol is proven to not stimulate significant tissue growth in the breast and uterus, and thus does not promote cancerous growth directly. Estrogen triggered cancerous tumors are believed to be a result of imbalance of the key estrogens, coupled with genetic triggers, and thus use of synthetic estradiols in birth control and hormone replacement therapy are believed to be significant causes of many breast and uterine cancers. Estriol is now compounded with a plant estrone for more specific effects. These topical bio-identical hormones are used in very low dosage and always combined with topical progesterone cream to insure a safe balance as your hormonal levels change.

Prior to the availability of these topical creams, the herbalist was limited to only a few estrogenic herbs, and a few androgenic herbs that indirectly stimulated progesterone production over a longer period of time. Now we are accumulating a number of options for effective treatment. Of course, treatment of hormonal levels may involve some fluctuation in hormones, and thus some temporary changes in symptoms during the course of the therapy. Any woman that experiences PMS understands that hormonal fluctuation can have dramatic results. These symptomatic changes are temporary and benign, and the end result is optimal hormonal health. Goal orientation is the key, as well as adherence to a consistent course of therapy.

What is the safety level of these herbs and cures?

To date, there has been no claims of health injury of consequence from the proper prescription of these natural cures, and acupuncture stimulation remains the safest treatment in human history, with virtually no complaints of injury in the United States other than a few cases of minor bruising or skin reaction. The malpractice cost to a practitioner of TCM is approximately one thousand dollars a year, reflecting the fact that there are no lawsuits. The TCM physician completes a graduate degree from a specialized medical school that requires much knowledge of medicine, modern and traditional, and usually includes extensive study in herbal medicine.

As progress is made in the research and clinical use of herbal medicines and acupuncture to regulate the body, many more specific uses of herbs will be uncovered. The body of knowledge grows every day. What is important is that you take products with reliable quality and the proper dose. This is accomplished by choosing a TCM physician with the knowledge and clinical experience to utilize quality herbal products and supplements and perform and coordinate care in a professional manner. The quality of products varies considerably and dosage claims are often false in a business that has no government regulation. It pays to utilize a professional to guide your care rather than to rely on self medication.

In my practice I have helped many women with menopausal problems, infertility, premenstrual symptoms and infrequent menstruation. The benefits from this treatment extend far beyond the immediate cure because improvement in the hormonal health is the foundation for improvement in many areas. Increased vitality, mental ability, less pain, lowered cholesterol and blood sugar, reduced blood pressure, prevention of cancer, osteoporosis and stroke, a healthier sex life, improved skin health, and many other benefits are part of the package in holistic care. Instead of harmful side effects we give you healthy side effects. If you need more information, call and schedule a free short consultation. You won’t regret it.

Information Resources

• Research in 2011 at the Universidade Federal do Rio Grande do Sul, in Porto Alegre, Brazil, stated that decades of research make clear that ionizing radiation is a potential cause of both hypothyroidism and hyperthyroidism, as well as thyroid nodules: http://www.ncbi.nlm.nih.gov/pubmed/22011852
• A 2011 report issued by the National Cancer Institute, NIH, of the U.S. Institutes of Health in Bethesda, Maryland, states that the threat of excess accumulative radiation from CT scans, which accounted for 47 percent of collective effective radiation from diagnostic procedures in 2008, and is growing yearly, is directly associated with rising rates of thyroid cancer incidence. This finding directly reflects on the potential of excess radiation from multiple CT scans in the lifetime to cause hyperthyroidism: http://www.ncbi.nlm.nih.gov/pubmed/21296564

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.