What Are Bio-Identical Hormones

Bio-identical hormones have the same chemical structure as hormones that are made by the human body The key to natural or bio-identical versus synthetic is the molecular structure of the hormone. In order for a replacement hormone to fully replicate the function of hormones which were originally naturally produced and present in the human body, the chemical structure must exactly match the original.

Side chains may be added to a natural substance to create a synthetic product that can be patented by a manufacturer. These structural differences may be responsible for side effects that are experienced when non-bio-identical hormones are used to replacement therapy.

A primary reason for the confusion encountered when reviewing studies of efficacy, safety, and side effects of various forms of HRT is that most studies have grouped all forms of estrogen under the title "estrogen replacement therapy," and the various progestins as well as progesterone under the name "progesterone," and often have failed to delineate the specific type of hormone that was investigated. 

Restoring Hormonal Balance

Bio-identical Hormone Therapy (BHT) is the replacement of deficient hormones with hormones that are chemically identical to those that the body naturally produces, but which have declined due to gaining or illness. BHT has improved the quality of life for millions of women and men who suffer from hormonal imbalance. The ideal process for achieving hormonal balance includes an assessment of hormone replacement of the deficient hormones in the most appropriate dose via the most effective route, and monitoring to fine tune the therapy. Estrogens, progesterone, and androgens are just the "tip of the iceberg" when it comes to achieving hormonal balance. Thyroid and adrenal function, as well as nutritional status, should also be evaluated and treated when indicated

Every person is unique. Therefore, it is sensible approach for health care professionals and patients to work together to customize hormone therapy. Bio-identical hormones can be compounded in the needed strength and dosage form and administered via the most appropriate route to meet each individual's needs.

 

Bio-Identical Hormone Therapy for Women

Estrogens

  • are a group of related hormones, each with a unique profile of activity.
  • are often prescribed in combination of re-establish a normal physiologic balance. The use of one or more of these hormones is referred to as Estrogen Replacement Therapy (ERT).

Bio-identical estrogens have been shown to clinically effective

  • for the treatment of menopausal symptoms.
  • for the treatment of postmenopausal problems including vaginal atrophy, dryness, or infections, painful intercourse, and various conditions of the urinary tract.
  • in decreasing the risk of osteoporosis and colorectal cancer.

In contract to bio-iodentical estrogens, NON-bio-indentical conjugated equine estrogens (CEE) are commonly prescribed. These conjugated estrogens are derived from pregnant mares' urine; however, most estrogens found in horses are NOT naturally produced by humans. Published research has shown that the risk of breast cancer is increased with the long term use of CEE and the risk is further increased when the synthetic progestin medroxyprogesterone acetate (MPA) is added. 

Progesterone

  • is commonly prescribed for perimenopausal women to counteract "estrogen dominance"
  • minimizes the risk of endometrial cancer in women who are receiving estrogen.
  • is preferred by women who had previously taken synthetic progestins according to a Mayo Clinic study.
  • may enhance the beneficial effect of estrogen on lipid and cholesterol profiles and exercise-induced myocardial ischemia (reduced oxygen supply to the heart muscle) in postmenopausal women in contrast to progestins, such as medroxyprogesterone acetate.
  • has a different side effect profile than synthetic progestins such as MPA.

Androgens

Testosterone and dehydroepiandrosterone (DHEA) may be added to a woman's hormone therapy to alleviate recalcitrant menopausal symptoms and further protect against osteoporosis, loss of immune function, obesity, and diabetes. A decline in serum testosterone is associated with hysterectomy, and there are age-related gender-independent declines in DHEA and DHEA-sulfate. Additionally, ERT may cause relative ovarian and adrenal androgen deficiency, creating a rationale for concurrent physiologic androgen replacement.

 

Hormone Therapy for Men

Men frequently experience declines in testosterone levels that correlate with the hormonal changes that women experience during menopause; however, men typically have a slower and more subtle decline, and develop symptoms over a period of time. When hormones are replaced or restored back to physiologic levels considered normal for younger males, men may experience a dramatic reversal of many of these changes.

In clinical trials, Testosterone Replacement Therapy has produced

  • improvement in psychological well-being and mood.
  • improvement in erectile dysfunction and libido
  • increased muscle mass, strength, and stature.
  • preservation of bone mass  

Testosterone therapy may not only treat hypogonadism, but may also have tremendous potential to slow or halt the progression from metabolic syndrome to overt diabetes or cardiovascular disease via beneficial effects on insulin regulation, lipid profile and blood pressure. 

Natural testosterone must not be confused with synthetic derivatives or "anabolic steroids," which when used by athletes and body builders have caused disastrous effects. Hormone balancing for men may also include dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), chrysin, zinc, selenium, and other supplements.

 

Thyroid Hormone Therapy

symptoms of hypothyroidism (low levels of thyroid hormone) include fatigue, cold and heat intolerance, hypotension, fluid retention, dry skin and/or hair, constipation, headaches, low sexual desire, infertility, irregular menstrual periods, aching muscles and joints, depression, anxiety, slowed metabolism and decreased heart rate, memory impairment, enlarged tongue, deep voice, swollen neck, PMS, weight gain, hypoglycemia, and high cholesterol and triglycerides. Yet, more than half of all people with thyroid disease are unaware of their condition.

T4 (thyroxine) is in an inactive form of thyroid hormone that is converted in the body to T3 (triiodothyronine), the active form. Some hypothyroid patients remain symptomatic T4 on T4 therapy and T3 may also be required for optimal thyroid replacement therapy. However, the only commercially available form of T3 is synthetic liothyronine sodium in an immediate release formulation which is rapidly absorbed and may potentially cause serious side effects including heart palpitations. 

Research indicates that to avoid adverse effects, patients and their physicians may wish to consider the use of sustained-release T3 in the treatment of hypothyroidism, particularly when the response to levothyroxine (T4)  has not been complete. Another option is using a physiologic blend of T4/T3.

 

"Adrenal Fatigue" (Hypocortisolism)

The adrenal glands secrete hormones such as cortisol, estrogen, and testosterone that are essential to health and vitality and significantly affect total body function. Anti-inflammatory and anti-oxidant adrenal hormones like cortisol help to minimize allergic and negative reactions, such as cancer and autoimmune disorders. After mid-life, the adrenal glands gradually become the major endogenous source of sex hormones in both men and women. Intense or prolonged physical or emotional stress commonly associated with modern lifestyles or chronic illness can lead to "Adrenal Fatigue," which is an important contributing factor in health conditions ranging from allergies to obesity.

These hormones closely affect the utilization of carbohydrates and fats, the conversion of facts and proteins into energy, and cardiovascular and gastrointestinal function. Proper adrenal support is essential to complete the hormonal pathway to optimal health, and includes proper nutrition, getting plenty of sleep, regular moderate exercise, stress management, slowing down to regain a proper perspective on life, and replacement of deficient hormones. 

 

Bio-Identical Hormone Replacement Therapy