Bioidentical Hormone Replacement Therapy (BHRT) is a popular topic these days. Much of the interest has been initiated by aging Baby Boomers who are extremely interested in maintaining active,vital lifestyles throughout the remainder of their years. Popular culture icons such as Oprah, Dr. Phil and Suzanne Somers have also generated curiosity and interest. Hormone optimization plays a significant role in anti-aging, but it’s not only beneficial for those of advancing age. Hormonal imbalance can occur at any age, and treating even mild hormone deficiencies can dramatically improve your quality of life.
But what is Bioidentical Hormone Replacement Therapy? The term ‘bioidentical’ means that the
molecular structure of the hormone is identical to that which is produced by our own bodies. BHRT
is a clinical specialty where the physician measures your current hormonal status and utilizes that
information to bring you to an optimal, balanced state. Surprisingly, it is not just about estrogen,
progesterone and testosterone; Hormones such as thyroid, insulin, pregnenolone, human growth
hormone, cortisol and other adrenal hormones are all measured and addressed as well.
When considering BHRT, know that when your physician interprets your laboratory results as
“normal,” that doesn’t necessarily mean “optimal.” While your hormone levels may be within
defined, safe ranges, they may not be at levels that will enable you to be the best version of
yourself. The best example of this is your thyroid hormone. In 2006 the American College of
Endocrinology found that a TSH greater than 3 often indicated clinical hypothyroidism and in 2010
the Annals of Internal Medicine reported that most people feel better with a TSH less than 2. Yet,
most current laboratories report abnormal as greater than 4.6. If your physician is unaware of
current studies, there’s a good chance your thyroid hormone isn’t being addressed correctly.
Even with BHRT, lifestyle choices are still a fundamental part of your success. Your clinician should
factor lifestyle choices when developing your personalized plan. If you do believe that BHRT may
be a good option for you, be sure and consult a qualified physician. Every individual has a unique
physical, genetic and hormonal composition. The way certain hormone replacements may
assimilate into one person’s body may differ in another. Although some over-the-counter products
claim to be natural hormone therapy, natural isn’t necessarily bioidentical and they may not function
in your body in the same way as the hormone your body produces. In addition, you don’t want to
supplement a hormone that is not in a deficiency state. Dosage is also not “one size fits all.
Thyroid – Synthroid is available from any pharmacy. It is a synthetic bioidentical hormone
replacement. Sometimes with synthetics, there are issues tied to conversion within the body. It is
important to know how your body chemistry will respond to this type of replacement. With generic
solutions, while the FDA does regulate the active ingredient, binders and fillers can vary. Some
generic versions of Synthroid are made with fillers that contain lactose or magnesium stearate,
which can inhibit absorption into the body. Symptoms of Hypothyroidism may include constipation,
fatigue, weight gain, brain fog, dry skin, and fertility problems. Optimizing your thyroid levels may
help you to gain vitality and even become pregnant, if that is your desire. However, it is also
important to know that factors like yo-yo dieting, low calorie dieting and stress, can impact your
ability to assimilate correctly. The lesson here – work with your doctor to take a whole body
approach to tackling thyroid issues.
Adrenals – Most of us identify our adrenals as our “stress management/fight or flight” hormones.
Imbalances in adrenals may be caused by unmanaged stress, aging, genetics, and environmental
factors. There has been a significant amount of research conducted on Adrenal Fatigue, which can
adversely affect our immune system and cause us to become susceptible to colds and airborne
illnesses. Getting your adrenals in check can make a significant difference in your overall health.
Cortisol – Too much cortisol and too little cortisol are both concerning. There is a fine balance
that your body should maintain when it comes to this hormone, and self-medicating with herbs can
be dangerous. Unbalanced cortisol levels can lead to hypertension, cardiovascular disease and
depression, as well as decreased libido and erectile dysfunction.
Andropause – Sometimes referred to as a man’s version of menopause, Andropause refers to
decreased testosterone levels in aging men, leading to symptoms such as erectile dysfunction,
dementia, general frailty, heart disease and diabetes. Testosterone replacements are available at
your local pharmacy, but typically require pre-authorizations by insurance for coverage. The
downside is, most insurance companies require testosterone levels to be in the lowest 2.5% for a
particular age range in order for that patient to receive coverage on the therapy. For that reason,
many patients must pay out of pocket. Compounding pharmacies can be a less expensive way to
go if you are one of those individuals that does not have insurance coverage for your therapy.
Progesterone – This hormone, popularly tied to PMS, should maintain a delicate balance in the
female body. Optimizing progesterone levels is critical for aging women and should be monitored
carefully by you and your physician.
Estrogen – Menopause. Hot flashes. Dryness. Brain fog. Incontinence. All of these symptoms can
be a result of unbalanced estrogen levels. There have been highly contested studies that show the
drug Premarin may have caused cancer in certain patients. This drug’s manufacturer states that
Premarin is obtained exclusively from “natural sources.” The natural sources include pregnant
mare’s urine (this is what “Pre-mar-in” stands for). There have been studies that link this drug to
higher incidences of breast cancer. It was determined that the type of estrogen used in the drug, as
well as the delivery method used in trials (oral), were not optimal. We now know that transdermal
application of this drug is much safer and delivers the hormone to the bloodstream and tissues in a
way that nature intended. Overall, estrogen therapy can be very beneficial if administered with the
careful supervision of a trained professional ensuring therapy is administered with the correct
method and dosage.
Insulin – We have an epidemic of insulin resistance in our country due to poor diet and lack of
exercise. Insulin levels that haven’t been optimized can result in fatigue, diabetes and inflammation
(which can cause cancer). For those with diabetes, not taking measures to control their sugars will
lead to dementia, so insulin levels are not something to take lightly.
Human Growth Hormone – In recent advertisements Sylvester Stallone pitches the benefits of
HGH. It’s true, Human Growth Hormone does in fact make a person appear stronger and more
youthful; However, HGH is not a magic cure. The bottom line here is you have to maintain a
healthy lifestyle as well.