Hormonal Imbalances — Causes, Consequences and Corrections

Paul Reller, L.Ac.

Hormones are a class of molecules that do not alone produce effects in the body, but instead are used to trigger other molecular effects by stimulating a wide variety of protein receptors. The word hormone is derived from the Greek hormao, meaning to arouse, or set in motion. Because of this relatively simple activity, many hormones are very similar in structure. This allows the body to easily transform one hormone into another as needed. A very complex system of feedback balance is therefore at the heart of hormone metabolism, and this is called the endocrine system. Endocrine simply means internal secretion, and this secretion of hormones occurs at a very large number of tissues in the body, not only at principal glands such as the adrenal, hypothalamic, pituitary, ovarian, testicular, and thyroid, but also from groups of cells in tissues throughout the body. Hormones are produced and secreted from our fat cells, from our bone marrow, from our organs, from breast tissue, etc. As scientific research advances, our notions of hormonal production and holistic feedback balance becomes more and more complex. All of this knowledge of hormones and the widespread hormonally secreting cells brings us to the practical realization that hormonal health must be achieved through a holistic process, and helps us to realize that the failure of allopathic medicine to safely and effectively control our hormonal imbalances are tied to this fundamental principle.

Hormonal health problems occur when particular hormonal levels in the body are not maintained within a physiologically normal, or optimum, rate of secretion in relation to other hormonal secretion rates. Maintaining endocrine function and balance is the key to hormonal health. Substituting synthetic hormones leads to a decrease in the function of the hormonal glands that maintain this balance, and an inability to maintain normal hormonal production. Restoration of endocrine function and balance is the optimum treatment strategy.

This does not mean that we are to abandon our current approaches with specific hormone therapies, but rather that we must expand our medical approaches to include Complementary Medicine and what it can contribute to the restoration of hormonal function and balance. Just as in cancer adjunct therapy, we must also utilize Complementary Medicine to alleviate and prevent the side effects that occur when we use synthetic hormone therapies. By using pharmacological hormones only when necessary, and taking a more realistic attitude toward what the public really sees as acceptable risks, we might realize that Integrative Medicine holds much promise in this area of endocrine restoration.

Currently, the pharmaceutical approach to hormonal therapies involves use of synthetic variants or analogs to our natural hormones. The main reason for this strategy centers around the fact that our drug patenting process requires that we create a new chemical product if we are to get a patent. Naturally occurring hormones, found in simple molecules, often identical in plants and animals, cannot be patented. Potential for huge profit is thus removed when we utilize these bioidentical hormones. Choosing to utilize synthetic variants of our hormones to achieve particular goals in therapy is a sound approach when benefits outway risks. Many people have found this to be a simple solution to prevent pregnancy or to counter an acute severe inflammatory reaction, and short term use with low dose often poses few problem for hormonal health. Do not mistake this use of hormonal chemicals as a substitute for the actual process of balancing and restoring hormonal health. The failure of hormone replacement therapy and findings of unacceptable health risks should not be forgotten, and both the public and the medical doctors should, and are, finding that a new fundamental approach must be taken to restore hormonal balance and health with Complementary Medicine. As with many types of therapeutic protocols in Complementary Medicine, this process may not be as simple as we would like it, but keep in mind that success with holistic medicine in restoration of hormonal balance and health will be lasting, and you will not be dependant on chronic use of the therapies.

Adrenal insufficiency and cortisol imbalances may be driving a host of subclinical hormonal pathologies, such as subclinical hypothyroidism, hyperparathyroidism, hypothalamic insufficiency, and even neurodegenerative conditions

Adrenal insufficiency may be a primary or secondary disease. Standard allopathic medicine has always focused on the primary adrenal pathology, usually related to damage to the adrenal cortex in Addison's disease, cancer, autoimmune destruction, or tuberculosis. A much more prevalent disorder is adrenal insufficiency secondary to causes outside of the adrenal and pituitary, which often begins and advances slowly and subclinically (no apparent clinical symptoms, or red flags). Secondary adrenal insufficiency may give normal aldosterone and angiotensin levels on lab analysis, but diurnally low or fluctuating cortisol levels, and low ACTH (hypothalamic function). Secondary adrenal insufficiency, when seen abruptly, is usually a result of abrupt withdrawal of steroid hormonal treatment. Since the use of corticosteroid therapy is now increasingly prescribed for a number of disorders, without apparent concern as in the past, this is a big potential public health problem.

Corticosteroid, or glucocorticoid therapy, is used both in low and high dosage, internally, topically and with inhalers. Steroid treatment chronically suppresses the hypothalamic-pituitary-adrenal axis by supplanting it, and abrupt withdrawal can present significant problems for the patient. The strongest standard corticosteroid medication is prednisone, which is given often in acute situations where inflammatory reactions and drug hyperactitivity reactions seem out of control, and even in chronic disorders such as arthritis, bursitis, tenosynovitis, rheumatic disease, psoriasis, dermatitis, asthma, allergic rhinitis, angioedema etc. In many cases, a short course of synthetic corticosteroid will reverse acute crises in emergency care. These synthetic corticosteroid medications are often withdrawn abruptly, rather than in a gradual decrease of dosage, despite the risk of developing a secondary adrenal insufficiency. The reasons for too abrupt withdrawal of corticosteroid medication may be due to patient noncompliance with therapeutic directions, or may be due to improper dosing withdrawal by the prescribing medical doctor. Prednisone withdrawal syndrome may result in acute severe hyperglycemia, loss of adrenal function, immune deficiency and a quick advance of opportunistic infection, diabetic retinopathy, and central nervous system disorder. Current guidelines call for gradual dose reduction whenever prednisone is prescribed for more than 7 days to avoid adrenal insufficiency and a withdrawal syndrome. Milder forms of corticosteroid withdrawal pathology may result in chronic adrenal insufficiency, though, often undiagnosed.

Many medical experts agree that adrenal insufficiency related to the increasing use of glucocorticoid medication is now common. These corticosteroids were once reserved for serious rheumatoid conditions that did not respond to any other therapy, but now corticosteroids are seen in drugstore medications obtained without a prescription or guidance, and many patients may be taking multiple low dosage corticosteroid medications. Many of these medications are taken as needed, as with asthma inhalers and topical steroid creams, and abrupt changes in dosage have a negative impact on the Hypothalamic-Pituitary-Adrenal Axis, or main systemic regulatory control of our endocrine balance. In 2011, Dr. Maria Magiakou M.D. and associates in endocrinology at the University of Athens Medical School, published a new online textbook in endocrine pathology (Endotext.org), and stated: “Primary and secondary adrenal insufficiency related to natural causes is uncommon, whereas iatrogenic, tertiary adrenal insufficiency caused by suppression of the Hypothalamic-Pituitary-Adrenal (HPA) function by glucocorticoid administration is common. Glucocorticoid treatment may not suppress the HPA axis at all, or it may cause central suppression or complete adrenal gland atrophy. Supraphysiologic glucocorticoid doses inhibit both CRH (corticoid releasing hormone) production by the hypothalamus and ACTH production by the pituitary gland. When this inhibition lasts longer than the duration of the glucocorticoid exposure, it is called adrenal suppression. Since the introduction of glucocorticoids in the treatment of rheumatoid arthritis in 1949, the therapeutic applications of these drugs were greatly broadened to encompass a large number of nonendocrine and endocrine diseases. Long-term glucocorticoid use worldwide is estimated at between 1% and 3% of adults. The glucocorticoid-induced adrenal suppression, when glucocorticoids are used in supraphysiologic doses, renders the adrenal glands unable to generate sufficient cortisol if glucocorticoid treatment is abruptly stopped and the patient develops glucocorticoid deficiency manifestations.” Of course, the long-term use of glucocorticoid therapy in the United States is much higher than the rest of the world, and this is presenting an alarming incidence of subclinical adrenal insufficiency in the U.S. population.

Glucocorticoid prescription has long been recognized as the most prevalent cause of secondary osteoporosis, and this is because the use of synthetic adrenal hormone cannot duplicate the complex diurnal rates of secretion of natural adrenal cortisone. Excess cortisone often results with use of synthetic cortisone medications, and synthetic medications do not duplicate all of the processess of natural adrenal hormones. Glucocorticoid use and adrenal insufficiency may play a significant role in the development of subclinical hypothyroidism and hyperparathyroidism as well, contributing to osteoporotic risk. Since hormonal health is a consequence of many parts of the hypothalamic-pituitary-adrenal axis, and the whole endocrine system, acting together in a complex systemic feedback mechanism, restoration of hormonal balance, rather than supplanting deficiencies with synthetic replacement, is a preferred method of promoting healthy function and avoiding adverse effects in the long term.

Hormone physiology and understanding of our hormonal health

Steroid hormones have been the subject of greatest interest to our hormonal problems in life. Steroids are a large family of chemical substances, comprising many hormones, body constituents, and drugs, all of which are built upon a particular chemical skeleton, composed of cyclic rings. Most of the steroid molecules are isomers, meaning that they exist as multiple forms that are identical with respect to the composition of parts, but that the position of these parts, or atoms, on the ring structure of the molecule, is different. This slight difference in structure is what the receptors react to, and hence different receptors are triggered in different ways by these slight variances between our hormones. Our endocrine system also is able to achieve easy transformation of one steroid isomer hormone into another as needed to insure bioavailability in our body. The most well known steroid hormones are the estrogens, progesterone, testosterone, corticosterone, cortisol, and aldosterone. Steroid hormones are all derived from cholesterol, and with the aid of various protein enzymes convert easily one into another. For this reason, a healthy cholesterol metabolism and bioavailability of the hormones that are normally precursors to the other steroid hormones are vital to restoration of hormonal health.

Cholesterol is an abundant steroid hormone, or sterol (steroid with an alcohol attached), with a large side-chain of hydroxyls that is removed to make our more well known steroid hormones. The normal chain of production of our steroid hormones starts with cholesterol turning into pregnenelone, and pregnenelone into progesterone or DHEA (dehydroepiandrosterone). Next we see progesterone turning into cortisol, aldosterone, estrone, or testosterone, and finally, both estrone or testosterone into estradiol as needed in the body. By observing this chain of steroid transformation, we see the importance of healthy cholesterol, pregnenelone and progesterone as building blocks for the production of the key pathological steroid hormones, estradiol and testosterone. Testosterone also turns into dihydrotestosterone, which is the form that activates many receptors linked to such problems as balding and prostate cancer and hypertrophy.

When we take a holistic approach to hormonal health, one aspect that we must consider, therefore, is the bioavailability of healthy cholesterols, pregnenelone and progesterone. When all of these are healthy, the chance of restoration of hormonal imbalance is greatly improved. This basic treatment protocol therefore involves improved quality of fats, the building blocks of lipid cholesterol, improved liver function, the site of most cholesterol production, clearing and regulation, and the controlled use of topical bioidentical hormone creams containing pregnenelone and progesterone production stimulators. Various herbal formulas and nutritional supplements are combined in this type of treatment, and acupuncture is an effective symbiotic therapy to help the body respond better to these nutritional therapies. The various herbs, supplements and bioidentical hormones mentioned here are extremely safe, and work very well when prescribed in the right way by a professional herbalist and knowledgeable Complementary Medicine physician, such as a Licensed Acupuncturist.

Misunderstandings of the cholesterol metabolism, and cholesterol as the fundamental building block of hormonal health

The exact same cholesterol molecule is found in all of our lipoproteins, the LDL (low density), HDL (high density) etc. that are commonly, and mistakenly, called our bad and good cholesterols, for our lipoproteins are not cholesterol, but merely contain cholesterol, and there are only two types of cholesterol, the normal healthy type, and the misshapen type that is removed and broken down by our liver. The lipoproteins, which are measured on our lab tests, are differentiated by types that primarily carry lipid, or fatty, molecules like cholesterol and triglycerides, to and from our liver. The LDL (low density lipoproteins) transport cholesterol out from the liver, the HDL (high density lipoproteins) transport old or misshapen cholesterol to the liver for excretion in the bile, and the VLDL (very low density lipoproteins) transport triglycerides from the liver and intestine to the fat cells for storage. Each of these lipoprotein types also carry other lipid molecules, and each carries cholesterol and apolar amino acids. The density of the lipoprotein is determined by the amount of protein (apolipoprotein), with HDL being made up of about 50% protein.

There are many misconceptions surrounding our cholesterol. Number one, that our cholesterol levels are bad if too high, and that our cholesterol levels are a product of our diet. In our body, cholesterol is very tightly regulated. If we eat more cholesterol, our bodies produce less, so that the right levels of cholesterol are maintained for our needs. When the cholesterol is of poor quality, the body removes it and turns it into bile, triggering increased production of more healthy cholesterol. What we measure on circulating blood tests are the circulating levels of lipoproteins, which are both carriers in our blood of cholesterol and other metabolites, and important constituents of our cellular and other membranes, such as the myelin sheaths on our nerves. The lipoproteins that attach to, or make up membranes, utilize cholesterol as a hormone that opens channels for transport through the membranes. It is true that high low density lipoproteins are associated with atherosclerotic plaque and increased risk of cardiovascular disease, but more exact research has found that this high LDL association may not be the actual cause of the atherosclerotic plaque, and that other associative markers, such as C-reactive protein and homocysteine levels are more accurate indicators of cardiovascular risk. Once we understand some of this important biochemistry, we see that blocking of production of cholesterol may not be such a good idea.

This lead us to the second common misconception, which is that cholesterol creates atherosclerotic plaque. While lipoproteins and cholesterol may accumulate in the atherosclerotic plaque, we have found over decades of research, that the real culprits in this disease are blood vessel inflammation and the attachment of both inflammatory regulating macrophages and various clotting factors to the sites of inflammatory damage. Clotting factors accumulate at sites of arterial vessel damage, to repair these sites. Our bodies are supposed to be able to clean out the clotting factors and fibers that repair the vessel, but when there is a type of dysfunction, the repair and elimination of plaque is hindered. When this healthy repair of arterial vessels is hindered, the atherosclerotic plaque continues to grow, until it narrows the artery, or worse, breaks off and travels to a narrow part or the artery, causing a blockage of blood flow that we call a stroke with an embolism. When these plaques around the inflamed areas of our vessels get too big, lipoproteins with cholesterol also attach, because lipoproteins are normal constituents of membranes. The approach to treatment of atherosclerotic plaque in Complementary Medicine is to aid the body in the task of maintaining healthy vessels and repairing the sites of atherosclerotic buildup.

Cholesterol controlling drugs, called statins, work by inhibiting the genetic expression of protein enzymes that are needed to create new healthy cholesterol. They also stimulate increase production of LDL (low density lipoprotein) receptors in the liver that remove cholesterol from the circulation. The increased need for LDL receptors reflects the deficiency of cholesterol that is available, but the same need of the liver cells for cholesterol to function properly. While these drugs have some modest effect on reducing production of cholesterol, the process is not a healthy process. Depriving the cells of cholesterol and increasing the need for cholesterol (LDL) receptors adds stress to the liver function. Decreasing circulating cholesterol, which is tightly regulated according to need of our cells and membranes, also produces potential health problems. The statins also do more than just target specific protein enzymes. The common side effects of statins involve pathological breakdown of skeletal muscle (rhabdomyolysis), decrease in the ubiquitous antioxidant CoQ10, derangement of liver enzymes, inducement of other genetic expressions, such as atrogin-1, which also promotes muscle fiber damage, and inhibition of creatine kinase, an important enzyme in the creation of ATP, the fuel for muscle contraction. While these problems only reach critical levels in a small percentage of patients, the processes are working to some extent in all patients. These side effects potentially create accumulative negative health effects over time, including muscle pain, joint pain, kidney stress, and increased accumulation of antioxidants and protein fragments in our tissues. They may also contribute to unhealthy myelin sheaths and neuropathy. Besides these accumulative side effects, the chronic use of statins is also alarming to many researchers and medical doctors, because they block production of healthy cholesterols, the building blocks of all of our steroid hormones.

A third cholesterol misconception is that the levels of cholesterol within our HDL (high density lipoproteins) is not that important. Studies have shown that decrease in HDL cholesterol is highly associated with deficiency of steroid hormone binding globulin (SHBG), which is a blood transport protein for testosterone and estradiol. Concentration of SHBG, like all hormonal metabolism, is regulated by a feedback mechanism controlled by levels of testosterone and estradiol. SHBG is also, like HDL cholesterol, produced and secreted mainly by the liver. During menopause, this steroid hormone binding globulin decreases considerably in many women. The result is that there is less circulating testosterone and estradiol, and the body responds by producing more testosterone and estradiol in the adrenal glands, leading to increased adrenal stress along with the lower circulating testosterone and estradiol. When HDL cholesterol levels are also low, this problem could be even worse, since low HDL cholesterol is associated with deficiency of SHBG. What we see on active hormone metabolite tests with these patients are cortisol levels that do not react as well as we need during the day, but then overact in the evening and at night, contributing to night sweats, heat flush and insomnia. Cortisol is a primary adrenal hormone, and with increased adrenal stress the diurnal cortisol rhythm is upset. We thus need to maintain a healthy level of HDL cholesterol, especially when we go through periods of hormonal deficiency, as in menopause. To confirm these facts, refer to the study cited below in additional information.

The fourth misconception concerning cholesterol lowering drugs that has emerged with recent studies, and is a cause of much concern in Washington, is that lowering cholesterol levels with these drugs actually reduces the risk of heart attack and strokes. Studies have shown significant lowering of LDL lipoproteins, yet have not shown significant reduction of cardiovascular events.

Hormone receptors and their role in a healthy hormone metabolism

Unlike our hormones, the protein receptors that react to hormones can be complex. These receptors react not only to hormones, but to neurotransmitters, and to antigens. Antigens are any substance that triggers an immune response, or a hypersensitivity response, and which reacts to antibodies or other immune cells. We thus see an intrinsic connection in the endocrine system to our neurological system and our immune system. In fact, many of our neurotransmitters, such as serotonin, also function as hormones. Our hormonal health depends upon optimal function of all three systems, the endocrine, immune and central nervous systems. A growing interest in such holistic fields of study as psychoneuroimmunology shows that we can no longer treat these systems as distinct entities when devising treatment protocols. The fact that hormone receptors react to antigens also means that accumulations of environmental toxins, which often trigger an antigenic response, may play a significant role in our hormonal imbalances. For example, inflammatory cytokines have been shown to affect the expression of estrogen receptors, and estrogens have been shown to reduce the overexpression of key inflammatory cytokines involved in chronic autoimmune inflammatory diseases, such as TNF-alpha, IL-6 and IL-1. Bacterial endotoxins have been shown to stimulate a chronic overexpression of these same problematic cytokines. Hormonal health and balance is integrally tied to immune health, and the health of the immune barrier in the intestines is integrally tied to hormonal health.

We see from numerous studies that hormonal receptors are found on a large variety of cells in the body, with hormones exerting significant effects on the immune cells and the expression of both pro- and anti-inflammatory cytokines, and on cells of the autonomic nervous system, as well as neurons and support cells of the central nervous system. Studies also tell us that these receptors are stimulated by immune cytokines and neurotransmitters. Often, the types of receptors expressed modulates functional aspects of hormonal modulation. For instance, there are two types of estrogen receptors, alpha and beta, and the imbalance of expression of one type over another is integrally tied to breast cancer. Research has shown how overexpression of one type of receptor inhibits the natural apoptotic, or programmed cell death cycle, of breast cells, allowing some cells to live abnormally long lives and be subject to increased mutations that eventually result in cancerous growth. Not just estrogen in general, but an array of factors are involved in the normalization of estrogen receptor balance, and the complexity of this process that the body has evolved is enormous. Imbalances in inflammatory cytokines, neurotransmitters such as serotonin, metabolic chemicals that affect local transformations of hormones, and the balance of a variety of hormones in the local tissues and circulation all have significant effects on the balance of hormone receptor expression and the effects of the local hormones on cell receptors. This complexity makes the strategy of an allopathic specific chemical mediator as a complete therapeutic protocol insufficient. Patient and physician needs to utilize Integrative and Complementary Medicine to restore normal and healthy homeostatic balance in all of these systems to insure the best outcome.

Drugs may also affect our hormone balance and hormone receptors. For example, estrogen and prolactin are hormones that have a reciprocal endocrinologic relationship, meaning that levels of one will alter the levels of the other. There are many known drug causes of prolactin abnormalities. Narcotics, diet pills, appetite suppressants, cough and cold formulas, and benzodiazepines, prescribed for anxiety and depression, all have been studies and found to have prolactin altering effects. The now banned Phen-fen diet drug was also found to have long-term prolactin altering effects, and misuse of this drug that was derived from the active ingredients in the herb ephedrine, may still be effecting patients that were given this drug by their M.D. The common pesticide MTX has been found to alter prolactin secretion. Synthetic estradiol benzoate in hormone replacement therapy was found to have a dramatic effect. Common antidepressants and other drugs which have an affect on catecholamines such as dopamine and norepinephrine were also found to have dramatic effects on prolactin levels. Prolactin is a hormone rarely tested in hormone pathologies, yet a number of drugs and chemicals are known to affect levels by competing at hormone receptor sites, and this has a direct reciprocal relationship to chronic estrogen deficiencies.

Research by Robert W. McMurray, at the University fo Misissippi Medical Center Rheumatology Section, found that both estrogen and prolactin had possible pleiotropic effects on the immune system, also. This means that they potentially have similar effects to immune modulators, related to a single allele, or gene mutation, that is usually unrelated. If an allele, one of the pair of genes needed to effect gene expression, is mutated, either by inherited trait, or by the mutating effects of environmental toxins, drug side effects, or chronic inflammatory processes, the expression of prolactin, or the estrogens, can produce health problems related to immune response. In these cases, the symptom presentation is complex, and diagnosis is often overlooked. Effects on prolactin, as we have shown, may also have reciprocal effects on estrogens, and trigger these unwanted immune responses, such as autoimmune disorders, which include rheumatoid arthritis and other chronic painful conditions. We see that various potential problems that could affect our hormonal system in ways that are confusing to us and to our doctors, and that this could explain why some of us acquire autoimmune disorders. To treat these hormonally related immune problems we must consider a number of treatment protocols, including reducing the potential drug side effects, clearing food allergy related antigens, antioxidant therapy to reduce genetic mutations, etc. These therapeutic protocols can seem confusing and excessive at first, but with some education the patient can realize the logic to this approach, and embrace Complementary Medicine.

There is no single ‘silver bullet’ in this therapy of hormonal balancing. Instead, there are a lot of choices to consider and incorporate into the right protocol for the individual. The patient needs to find a knowledgeable Complementary Med physician or integrative physicians to guide them along this course. The TCM physician, or Licensed Acupuncturist, may provide this knowledge along with herbal protocols, acupuncture, dietary supplements and counseling on diet and lifestyle changes, and integrate with your Medical Doctor. The key in integrative therapy is to choose a doctor has adopted an open mind, and has taken the time to explore current research.

Is there proof that these treatments will be effective?

Yes. There is a wealth of sound research supporting acupuncture and herbal medicine in adjunct care with hormonal therapies.

Researchers at the University of California San Francisco have recently engaged in an official exchange of information with Peking University in China on herbal research and have published one of the first studies to result from this valuable collaboration: Selective Activation of Estrogen Receptor-beta Transcriptional Pathways by an Herbal Extract, published in Endocrinology Vol. 148, No. 2, 538-547: The authors state: "Our results demonstrate that herbal estrogen receptor beta-selective estrogens may be a safer alternative for hormone therapy than estrogens that nonselectively activate both ER subtypes." The TCM herbal formula studied was shown to accomplish the same task as Tamoxifen, a synthetic estrogen that treats both osteoporosis and breast cancer by inhibiting estrogen receptors. Tamoxifen works by selectively binding to one estrogen receptor type to effectively inhibit the effect of estradiol on the other. The chemicals in the herbal formula was found to bind to both estrogen receptors and modulate the responses, recruiting coregulatory proteins that are required for gene activation. The formula did not activate the estrogen receptor alpha-regulated proliferative genes or stimulate breast cancer cell proliferation or tumor formation in animal studies. The herbal formula would thus not induce hot flush or other side effects related to hormonal imbalance that Tamoxifen produces.

The abundance of such research prevents me from citing all of it in this article. As time goes on, I will present links to key scientific studies below. While this article is perhaps technical and difficult to fully grasp by many patients, I hope that those patients that are afflicted with hormonal pathologies take the time to try to better understand the physiology and realize how Complementary Medicine can help you to take a proactive approach and overcome these difficult health problems.

Information Resources

1. Hormonal therapy in the form of oral glucocorticoid medication is becoming more prevalent in the United States and long-term risks of this therapy have not been sufficiently studied. This 2004 study of over 50,000 patients by the Utrecht Institute in the Netherlands, the University of Montreal, Southhamptom University Medical Research Council in the UK, and the University of Edinburgh, found that very few studies have been conducted to determine the cardiovascular risk of glucocorticoid prescription, but that these medications were identified with increased risk for heart failure. In addition, these experts agreed that evidence shows increased risk for osteoporotic fractures, fluid retention, obesity, hypertension, hyperglycemia, and perhaps stroke.: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768386/
2. A 2006 survey of chronic glucocorticoid users by the University of Alabama concluded that there was a high prevalence of side effects or adverse health effects with normal long-term prescription use of glucocorticoid medications, including weight gain, cataracts, and osteoporotic fractures, with 55% of patients reporting at least one adverse health effect was very bothersome. Among low-dosage users, long-term use was significantly associated with acne, skin bruising, weight gain, and cataracts. All groups showed a strong association with the dosage.: http://www.ncbi.nlm.nih.gov/pubmed/16739208
3. A 2006 survey of physician practices by the University of Texas Medical School found that physicians do not routinely evaluate patients for osteoporosis secondary to glucocorticoid treatment despite the fact that this class of drugs is the most common cause of iatrogenic osteoporosis, or osteoporosis induced by standard therapy. The persistent failure to recognize adverse health effects of gluocorticoids such as prednisone as the rate of prescription of these drugs increases has alarmed many medical experts.: http://www.jaoa.org/cgi/content/full/106/11/653
4. A 2010 study in Czechoslovakia, at the Institute of Endocrinology in Praha, noted that standard treatment for subclinical adrenal insufficiency, or hypocorticism, in patients with diabetes type 1 remains questionable, and that risk of glucocorticoid overdose persists with standard prescription because oral administration of glucocorticoids cannot fully mimic the diurnal rhythm of natural glucocorticoid secretion, in spite of newly developed drug forms. Restoration of adrenal and hypothalamic function in subclinical adrenal insufficiency would insure greater diurnal contol of blood sugars and prevent adverse effects of glucocorticoid overdose: http://www.ncbi.nlm.nih.gov/pubmed/20429347
5. A study at the Hollings Cancer Center of the Medical University of South Carolina found that estrogens may inhibit the T helper cell 1 (Th1) proinflammatory cytolines TNF-alpha, IL-12, and interferon gamma, but may also stimulate the production of the T helper cell 1 (Th2) anti-inflammatory cytokines IL-10, IL-14, and TGF-beta. Since chronic diseases may be moderated by Th-1 or Th-2 immune modulators, estrogen/progesterone imbalance and hormonal deficiency may play a part in these diseases. This helps to explain the high percentage of women that are afflicted with autoimmune disorders and chronic inflammatory diseases. It also points to problems with synthetic estrogen therapies, hormonal ablation, and other drug therapies that substitute or alter estrogen balance. http://www.ncbi.nlm.nih.gov/pubmed/15032646
6. A study linking deficiency of HDL cholesterol to poor transport of testosterone and estradiol is seen here: http://humrep.oxfordjournals.org/cgi/content/full/21/9/2266
7. Medical definitions of the various lipoproteins are available from the free dictionary online: http://medical-dictionary.thefreedictionary.com/lipoprotein
8. A number of Chinese herbs have been found to be protective against the risks of breast cancer from use of synthetic hormone replacement. Research into the activities that make the Chinese herb, Yun Zhi, or Coriolus versicolor, commonly called turkeytail mushroom, effective against multiple breast cancer cell lines shows that this herb help induce normal apoptosis, or programmed cell death, which is inhibited with hormonal imbalance and the use of hormone replacement therapies: http://www.ncbi.nlm.nih.gov/pubmed/15908782

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.