Why Bioidentical Hormone Replacement?


 Hormones are molecules that are synthesized and secreted by specialized cells often localized in endocrine glands. Hormones are released into the blood stream and exert biochemical effects on target cells. Hormone action is determined by the presence of specific hormone receptors located either on the cell surface or intracellularly in the target cells. Hormones turn on the cellular machinery and therefore cause increased metabolism, increase in protein synthesis, increase in cellular repair, and increase in cell replication. 

 All aspects of aging are influenced by hormones. As we age cellular receptor sites become less sensitive to stimulation by hormones, thus requiring an increased amount of hormone to affect a cellular change. This is precisely why people need optimal levels of hormones. And even though their levels might be normal, they still need more hormones in the body to improve and feel better. (This is particularly true with thyroid.) These changes in hormones result in decreased healing and repair of tissues. Research has now proven that hormone therapies are valid means to improve and prolong quality of life, thus showing that deficiencies in hormones and endocrine dysfunction can contribute to the signs and symptoms of getting old. 

 Sorry, nothing reverses aging. However, hormones can slow down the process and help us maintain our good health. True reversal of aging requires identification of genetic loci that control the aging process and the manipulation of these genes by genetic engineering techniques. Unfortunately, the technology to accomplish this age reversal by genetic engineering is not currently available. In the meantime, we must take advantage of the current state of the art, preventive medicine techniques which include avoidance of risk factors of disease, optimum nutrition, adequate exercise, caloric restriction, antioxidant therapy, and optimal hormone replacement. We can certainly slow down that aging process to achieve less deterioration, less illness, a better quality of life and to feel and function better. This is true Preventive Medicine. 

Biologically Identical Hormones

 You might ask, “If there are hormones available that are natural to my body, why do doctors prescribe synthetic hormones?” The explanation involves the powerful pharmaceutical industry in the United States, politics and economics. 

 The molecule of the natural hormone is identical in structure to the hormone naturally found in the body. Pharmaceutical companies cannot patent natural or bioidentical compounds. However, they can patent chemically different molecules that are highly profitable. A patent will guarantee that a pharmaceutical company will have an exclusive right to manufacture and profit from their product. After the tremendous monetary investment that goes into developing and studying a pharmaceutical product, it is logical that the pharmaceutical companies would want their investment protected with an exclusive, patented product. Therefore there is little research and minimal marketing of natural hormones. 

 A large part of marketing a drug involves the education and instruction of a physician on how and when to prescribe it. Much of what physicians know about drugs comes directly from pharmaceutical companies promoting a product. Because pharmaceutical companies don’t manufacture natural hormones, most physicians do not learn about them unless they do personal research. 

 Where do these natural hormones come from? The pure biologically identical (human identical) hormone is either extracted from plants or synthetically manufactured. What is most important is that the end product is a molecule identical to the hormone molecule found naturally in the body. This applies to all hormones — thyroid, estrogen, progesterone, testosterone and DHEA. 

 Where does one fill prescriptions for natural hormones? There is a special type of pharmacy known as a compounding pharmacy. These are regular licensed pharmacies that are capable of providing you with any drug from pharmaceutical companies. But compounding pharmacies are able to do more. The compounding pharmacist is similar to the old fashioned concept of a pharmacist with a mortar and pestle. They acquire the pure pharmaceutical grade hormone and compound it into the dose and form ordered by the physician. They produce pills, capsules, liquids and creams per the doctor’s prescription order for you. This makes your program very customized and personalized. 

 A bioidentical hormone has a chemical structure that is identical to the hormone naturally produced by the body. We refer to them as natural because they are natural to the human body. Natural hormones cannot be patented by drug companies. Synthetic hormones have a structure similar to but not exactly the same as a hormone produced by your body. These chemical differences mean that the synthetic hormone acts differently and produces substantially different effects. Natural (bioidentical) and synthetic hormones should not be considered the same or used interchangeably. They are entirely different. A multitude of studies have demonstrated many harmful effects of synthetic hormones whereas the medical literature supports no harmful effects of natural hormones, only beneficial effects. 

Hormone Replacement Therapy and Aging

 Hormones decline in all people as they age. Many physicians assume this is the natural way it should be. If a younger person were to be diagnosed as having a hormonal deficiency, it would be quickly corrected. However, the same low level in an older individual is considered normal for their age and not something we treat. Normal is a relative term. No one wants the hormone levels of an 80-year-old, but labs report this low level as “normal” even though it might be only 20% of the level of a 30 year old. Researchers from around the world have now shown that the hormonal deficiency associated with age should be corrected to that of a younger person. When patients see and feel the improvement, they embrace it wholeheartedly. It is not until one tries this new therapy and experiences the tremendous increased vigor that one realizes the harm that is being caused to the body by the lack of these hormones. The added benefit is that it is healthy too. 

 Thyroid, estrogen and progesterone have been prescribed for many years, but optimal hormone replacement is new. It has become logical therapy to replace and balance all of the hormones at the same time to a more optimal physiologic level instead of maintaining lower or mid normal levels. This is the difference between optimal hormone replacement in comparison with the standard medical therapy. Don’t wait for levels to be technically below a normal range. Accept a low normal level as not optimal and replace the hormone to high normal or optimal levels. Fortunately, many physicians as well as patients are able to key into the concept of optimal hormone replacement. Today, more and more medical practitioners are becoming aware of the science behind this new preventive medicine. 

 It has been shown that many changes seen in normal aging, including osteoporosis, muscle atrophy, sleep disorders and decreased sociability are in part caused by a decrease in hormones. Aging in man is associated with reduced protein synthesis, decreased lean body mass, decreased bone mass and increased body fat. The body composition changes are 

consistent with the progressive decline in the secretion of hormones. Replenishment of these hormones to physiological levels (optimal, but within normal limits and not excessive) has been shown to alleviate these age-related changes. Much of what goes wrong in old age is the effect of our hormones no longer maintaining the balance that they once did. In fact, the diseases that have become associated with normal aging, such as diabetes, heart disease, and hypertension are largely a result of what happens when the correct balance of hormone levels is upset. By restoring the proper hormone balance, immunity is restored, and this can prevent many of the diseases associated with the aging process. In summary, research has shown that declining hormone levels can cause many ailments associated with aging and hormone replacement is the only current solution to alleviate many symptoms. Many books recently written on hormone replacement therapy are filled with testimonials from patients praising its benefits. Many patients are typical, middle-aged, healthy people who experienced gradual increased symptoms such as decreased energy levels, decreased sense of well-being, laziness and lack of desire for common daily activities. Patients tend to lose muscle tone, gain fat around the mid section, and experience thin hair and thin skin. In addition to the symptomatic, degenerative problems, they will also experience increased cholesterol as well as signs of heart disease and arthritic change. Within six to twelve months of hormone replacement therapy, patients have noticed reshaped bodies, fat disappearing, increased muscle tone, and the energy of a younger person. Patients report an improved sense of well-being and an improved outlook on life. There are tremendous health benefits; there are great feel good benefits. 

 Unfortunately, up to 90% of today’s patient currently being prescribed “natural hormones” from their doctors are on inadequate regimens. How do we know? When we measure the blood levels they are near zero. In order for the hormones to be beneficial, the serum hormone levels must be kept within the optimal, upper limit of normal levels for a younger person. Most physicians are not trained to target optimal levels. 

 Many physicians do not understand how to prescribe the correct doses. They are not aware of the target optimal levels based on blood tests. They might not be aware of the many options in the compounding of a natural hormone in order to provide a type that is absorbed and metabolized by the individual patient.