Have you been experiencing weight gain, mood swings, sleep disorders, low or absent sex drive, memory disorder, the feeling of being tired or sluggish?

Have you been told that you have chronic fatigue, depression, thyroid disorder or fibromyalgia?

Hormone imbalances can occur in men and women of almost any age.1 A variety of factors can be related to these imbalances, including high insulin levels from diets high in refined foods and sugar, exposure to environmental toxins (xenoestrogens), high consumption of hydrogenated fats, and lack of physical activity leading to weight gain.2-5

Age is also a factor in reduced levels of hormones, creating feelings of imbalance in everyday pursuits. For example, testosterone levels in women begin going down after age 20. By age 40 a woman’s testosterone level will be half of what it was when she was 20 years old. This is why getting hormone levels checked even while in your 20′s may be necessary if you aren’t feeling yourself. For women between the ages of 40–60, testosterone levels can remain pretty constant. After menopause testosterone declines once again.1

How can you help hormones maintain balance?

Diet

The food you choose to eat can have a major impact on your health. If your diet is high in sugar, processed carbohydrates, hydrogenated fats, genetically modified foods, and conventional beef, dairy, and poultry, then you are more susceptible to obesity and all the associated diseases, plus an increase in hormone imbalances.6-11 It’s important to maintain a healthy weight, as storing excess fat can lead to hormone imbalances and an increase in stored environmental toxins. Toxins have a negative impact on overall health and should be avoided at all ages of life, especially during pregnancy where the developing baby can carry the negative impact the rest of its life.12-15

Exercise

Physical activity is important to hormone balance, not to mention overall health and a good mental state. Exercise helps to keep cortisol levels low and also helps maintain hormone balance by reducing the level of cortisol in the body and sustaining serum insulin levels. Cortisol levels can become significantly high when the body is experiencing stress, either real or imagined.17 Exercise helps counter the effects of stress and regular moderate exercise can lower cortisol levels.18-20 Moderate exercise for 30 to 60 minutes each day can have a profound effect on hormone balance.21-23

Bioidentical Hormones

Bioidentical hormone replacement therapy (BHRT) can balance hormone levels that become upset or deficient through lifestyle habits and aging. Unlike conventional HRT, BHRT is derived from plant sources and structured similarly to hormones circulating in the body.24-26 Since the Bioidentical hormones are recognized in the body, they are effectively assimilated and used. BHRT replenishes the body with the healthy hormone levels your body needs to function optimally. Forms of BHRT include progesterone, estrogen, and testosterone.

Blood tests are taken to determine hormone levels. If there is a deficiency or imbalance, BHRT is recommended to safely balance hormone levels. Restoring hormone balance can provide greater protection from chronic diseases and alleviate menopausal symptoms. Saliva testing of hormonal levels is used by some practitioners, but peer-reviewed studies from saliva testing are not nearly as prevalent. Serum hormone studies show the ideal levels to reduce the risk of heart disease and some cancers.

Compounding pharmacies specialize in producing BHRT. Doses are determined on an individual basis and available in different administrations (topical, oral, sublingual, etc.). A few studies show that topical BHRT has a better safety profile than the orthodox oral HRT.27-29 It is important to note that most physicians are not trained in prescribing BHRT and they may be unfamiliar with the medical literature that supports this treatment. Fortunately, there are physicians specializing in age-management medicine who can help you determine which BHRT treatments are best for you.

References

1. Rohr U. The impact of testosterone imbalance on depression and women’s health.Maturitas. 41 Suppl. 1 (2002) S25–S46.
2. Ruano M, et al. Morbid obesity, hypertensive disease and the
   renin-angiotensin-aldosterone axis. Obes Surg. 2005 May;15(5):670-6.
3. Masi AT, et al. Neuroendocrine, immunologic, and microvascular systems interactions in rheumatoid arthritis: physiopathogenetic and therapeutic perspectives. Semin Arthritis Rheum. 1999 Oct;29(2):65-81.
4. Nadal A, et al. The pancreatic beta-cell as a target of estrogens and xenoestrogens: Implications for blood glucose homeostasis and diabetes. Mol Cell Endocrinol. 2009 May 25;304(1-2):63-8.
5. Park SH, et al.  Cell growth of ovarian cancer cells is stimulated by xenoestrogens through an estrogen-dependent pathway, but their stimulation of cell growth appears not to be involved in the activation of the mitogen-activated protein kinases ERK-1 and p38. J Reprod Dev. 2009 Feb;55(1):23-9.
6. Kochan Z, et al. [Dietary trans-fatty acids and metabolic syndrome]. Postepy Hig Med Dosw (Online). 2010 Dec 27;64:650-8.
7. Biswas M, et al. Reduced total testosterone concentrations in young healthy South Asian men are partly explained by increased insulin resistance but not by altered adiposity. Clin Endocrinol (Oxf). 2010 Oct;73(4):457-62.
8. Kelly DM, et al. Testosterone: a metabolic hormone in health and disease. J Endocrinol. 2013 Apr 29;217(3):R25-45.
9. Pimentel GD, et al. Intake of trans fatty acids during gestation and lactation leads to hypothalamic inflammation via TLR4/NFκBp65 signaling in adult offspring. J Nutr Biochem. 2012 Mar;23(3):265-71.
10. Collison KS, et al. Effect of trans-fat, fructose and monosodium glutamate feeding on feline weight gain, adiposity, insulin sensitivity, adipokine and lipid profile. Br J Nutr. 2011 Jul;106(2):218-26.
11. Duque-Guimarães DE, et al. Early and prolonged intake of partially hydrogenated fat alters the expression of genes in rat adipose tissue. Nutrition. 2009 Jul-Aug;25(7-8):782-9.
12. Lang IA, et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008 Sep 17;300(11):1303-10.
13. Markowski VP, et al. Tissue-specific and dose-related accumulation of arsenic in mouse offspring following maternal consumption of arsenic-contaminated water. Basic Clin Pharmacol Toxicol. 2011 May;108(5):326-32.
14. Blüher M. Adipose tissue dysfunction contributes to obesity related metabolic diseases.Best Pract Res Clin Endocrinol Metab. 2013 Apr;27(2):163-77.
15. Silva AP, et al. Dietary fatty acids early in life affect lipid metabolism and adiposity in young rats. Lipids. 2006 Jun;41(6):535-41.
16. Eliakim A, Nemet D. Exercise training, physical fitness and the growth hormone-insulin-like growth factor-1 axis and cytokine balance. Med Sport Sci. 2010;55:128-140.
17. Turakitwanakan W, et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai. 2013 Jan;96 Suppl 1:S90-5.
18. Broocks A, et al. Effect of aerobic exercise on behavioral and neuroendocrine responses to meta-chlorophenylpiperazine and to ipsapirone in untrained healthy subjects.Psychopharmacology (Berl). 2001 May;155(3):234-41.
19. Marc M, et al. Plasma cortisol and ACTH concentrations in the warmblood horse in response to a standardized treadmill exercise test as physiological markers for evaluation of training status. J Anim Sci. 2000 Jul;78(7):1936-46.
20. Scerbo F, et al. S. Effects of exercise on cravings to smoke: the role of exercise intensity and cortisol. J Sports Sci. 2010 Jan;28(1):11-9.
21. Hill EE, et al. Exercise and circulating cortisol levels: the intensity threshold effect. J Endocrinol Invest. 2008 Jul;31(7):587-91.
22. Cust AE. Physical activity and gynecologic cancer prevention. Recent Results Cancer Res.2011;186:159-85. doi: 10.1007/978-3-642-04231-7_7.
23. Haff GG, et al. Force-time curve characteristics and hormonal alterations during an eleven-week training period in elite women weightlifters. J Strength Cond Res. 2008 Mar;22(2):433-46.
24. Watt PJ, et al. A holistic programmatic approach to natural hormone replacement. Fam Community Health. 2003 Jan-Mar;26(1):53-63.
25. Mahmud K. Natural hormone therapy for menopause. Gynecol Endocrinol. 2010 Feb;26(2):81-5.
26. Francisco L. Is bio-identical hormone therapy fact or fairy tale? Nurse Pract. 2003 Jul;28(7 Pt 1):39-44, table of contents.
27. Eilertsen AL, et al. The effects of oral and transdermal hormone replacement therapy on C-reactive protein levels and other inflammatory markers in women with high risk of thrombosis. Maturitas. 2005 Oct 16;52(2):111-8.
28. Kurtay G, et al. A comparison of effects of sequential transdermal administration versus oral administration of estradiol plus norethisterone acetate on serum NO levels in postmenopausal women. Maturitas. 2006 Jan 10;53(1):32-8.
29. Lazzeroni M, et al. The effect of transdermal estradiol or oral conjugated oestrogen and fenretinide versus placebo on haemostasis and cardiovascular risk biomarkers in a randomized breast cancer chemoprevention trial. Ecancermedicalscience. 2008;2:67.

Are you tired, irritable, having trouble sleeping? Depressed Anxious? Skin drying, suddenly gaining weight when diet and exercise haven’t changed, and libido lagging? These questions aren’t for women. They are for men. Bioidentical hormone therapy and testosterone therapy is available in Bend for men.

Men have as many issues with hormones as women, they have the same symptoms, but  it isn’t talked about as much. It’s truly unfortunate because men can benefit as much from education and bio-identical hormone therapy too.

First, men need to understand that they have more hormones than testosterone. Secondly, they need to understand that testosterone is important for overall heath, not just sexual function.

As I evaluate men’s health, i pay attention to five hormone functions: thyroid, insulin, testosterone, cortisol, human growth hormone and DHEA. All combined they regulate a man’s health and body function. Unfortunately, men don’t have a monthly ‘report card’ like women do, so it’s less clear when something or a combination of things is off track.

While women often initially cite emotional and psychological concerns like feeling anxious and depressed, men zero in on physical issues like middle-aged bulge, lack of energy or increases healing time after a minor injury. Men notice that their physical performance has changed, often they think they need to tough it out, but it’s more than enough reason to seek out some medical advise.

This is something that women can be very sensitive to, perhaps suggesting men in their lives to see a doctor. If a woman is changing metabolically, she can assume her male partner is too. It is not uncommon for a man in his 40’s and 50’s to see a significant drop in his production of testosterone, or see the thyroid function falter. Both result in symptoms like fatigue, being short-tempered, drying of skin and a vague sense of depression. But many men don’t seek help until sexual function is involved. That’s a man’s ‘report card’.

Once trouble with the prostate is ruled out, that’s when I as a specialist in bio-identical hormone replacement therapy can have a candid and comprehensive conversation about hormone balance and overall health. It’s all about goals with men once the labs are in and the numbers are on the table, most men are very willing to talk about diet exercise and treatments. Most often, they zero in on testosterone, and while improving intimacy is an important goal, hormonal balance is critical in protecting against heart disease and bone loss too. The first goal is to get the thyroid functioning at optimum levels, this gland is the traffic cop for any body, it has to be functioning well for other systems to work as they should. With that done, testosterone in the form of creams and injections can be considered. Bringing those levels up can significantly change how a man is feeling, both physically and emotionally. They will also see an increase in energy, brighter looking skin and better moods, The same feeling women experience when they are correctly balanced.

Many men are feeling the benefits of bio-identical hormone replacement therapy. Dr. Brust @ Preventative Medicine Clinic in Bend is a specialist in this area. However, don’t assume that testosterone is an easy fix. It requires consultations with the prescribing physician frequently, and having labs drawn at least twice a year, as testosterone is a controlled substance. Also don’t confuse hormonal balance with anabolic steroids, each have different goals, different dosages and different results. It’s best to focus on feeling your best regardless of your age. Men shouldn’t avoid the conversation, they should feel comfortable in seeking out options.  Testosterone is supplemented in a variety of forms: hormone pellets, creams, gels, and intramuscular injections.  To find out if this therapy is right for you, please contact Preventative Medicine Clinic in Bend @ 541-383-3424.

by Lori Gleichman, for The Bulletin Special Projects
Reprinted from The Bulletin’s U Magazine – June 2009

Bioidentical hormone replacement therapy has allowed some women to take back their lives. Two women who don’t know each other still have a lot of life experience in common, like finding themselves again after years of feeling “not quite right.” Both use words and phrases like lethargic, fuzzy thinking, “tired all the time,” extremely irritable, trouble sleeping, and night sweats to describe their symptoms. In essence, they were miserable and didn’t know why.
In both cases, they consulted their regular physicians who diagnosed depression or early menopause and prescribed pills. In both cases, they felt they needed something different and eventually had their hormone levels tested. The tests registered in the zero to “barely there” range. And both finally found a solution to their problems: bioidentical hormone replacement therapy (BHRT).
To some, BHRT is mysterious and controversial, but to Aileen Walker, 43, and Tonya McKiernan, 44, it is a treatment that has provided tremendous relief. “For me, the change was almost immediate,” said McKiernan.”

Their Stories
McKiernan experienced surgically-induced menopause when her ovaries were removed due to cancer. After suffering a variety of symptoms for years, she finally questioned the depression diagnosis and had her hormone levels checked. “Essentially, I had no hormones at all,” she said.
Walker had a similar experience, even though it has taken about a year to get her hormone levels to the point where “I feel myself again,” she said. Walker started feeling badly in her early 30s, but the symptoms escalated— irritability, fuzzy thinking, and drastic changes in her body —after the birth of her second child, Zach, at 38.
“In retrospect, I was probably having hormone imbalances for years, but after Zach, everything amplified,” she said. Doctors prescribed birth control pills after testing her hormone levels, which registered at the “barely there” mark. This didn’t sit well with Walker.
“I knew there had to be other options,” she
said. She consulted with Dr. Evelyn Brust, ND, LAC at Preventative Medicine Clinic in Bend and was amazed at the detail that resulted from the testing process and the discussion. “We went through every single line on the blood labs and discussed what it meant and why it was important,” Walker said. Walker left with a prescription for bioidentical hormone replacement therapy that has evolved over the last year to match every symptom with the right level of hormone. “Now I feel much better overall on every level,” said Walker. “I never knew hormones could make you feel so bad—or so good.”

The Power of Hormones
In fact, hormones make up one of the most important systems in our bodies. They act as chemical messengers that carry information between groups of cells, regulating growth, tissue development, sexual function, and how our bodies use food and react to events.
For women, important groups that influence how we feel are estrogen, progesterone and testosterone. In balance, they work together for health and wellness of both body and mind; out of balance, women can suffer from symptoms that seriously impact the quality of life like hot flashes; sleeplessness, irregular, heavy and painful periods, migraines and mood swings. These symptoms can start as soon as a girl starts puberty and be a problem throughout the years not just as symptoms of peri-menopause or menopause.
Ron Rosen, MD, PC with Open Paths Integrative Medicine in Bend, has seen an increase of women seeking advice about these symptoms for themselves and for their daughters, who seek alternatives to suffering or synthetic hormones. “Women are educating themselves more about health issues and have more awareness of their own bodies,” he said. “They are more willing to deal proactively with things and questioning traditional approaches to hormone replacement therapy.”
Rosen encourages people to do their research, talk to physicians in detail about symptoms and concerns. If not satisfied, look for other options. “Different practitioners offer different information and alternatives,” he said. Brust agreed. “Many of us know intuitively when something is wrong, even if it can only be talked about in terms of how we feel,” she said. “I think the integrative medicine community pays more attention to listening to patients, as well as doing the ‘science’ of medicine.”

Is BHRT the Answer?
To determine exactly what is wrong, Brust spends times with a patient discussing symptoms. She then runs a series of lab tests to determine baseline levels of hormones and other body chemistries. She also does a series of screenings for the heart, bone density, mammograms and PAP smears to determine any other risk factors that need to be considered in BHRT. Finally, she has a conversation about short- and long-term risks and benefits.
“I encourage women to look at life right now—what is critical to be addressed to make them feel better—but also to look at the future,” she said. “BHRT is preventative for many diseases like heart disease and memory loss, but people have concerns about risks as well even though there have been no studies to date that show a link between BHRT and cancers or heart attacks.”

Treatment Options

If BHRT is right for you, you will likely be referred with a prescription to a compounding pharmacy, which specializes in combining components for individual needs versus a dispensing pharmacy which doles out medications manufactured in an industrial setting.
You will also discuss a delivery method as BHRT is generally applied topically in a cream, in a troche that dissolves under the tongue, or a suppository.The compounding pharmacists also often plays a consulting role with patients, monitoring their symptoms and working with the physician to “tweak” the prescription to just the right levels, explained Barbara Dembsky, owner/pharmacists with CustomCare Rx in Bend. Dembsky said that people considering bioidentical hormones need to understand two things. First, the chemical structures of bioidentical hormones are identical to those produced by the human body, not simulated like synthetic hormones such as Premarin or Prempro. Secondly, each prescription is compounded specifically for each individual receiving the therapy—BHRT does not offer a “one-size-fits-many” approach.
According to the International Academy of Compounding Pharmacists, the final bioidentical hormone product is not regulated by a state or federal agency, but bioidentical hormones—like all compounded medications— are made from FDA- and USP- registered materials. “Compounding pharmacists are highly trained and subject to state board of specification standards,” Dembsky said. Both McKiernan and Walker agree that they “just feel better,” and encourage women to talk to one another about their experiences with hormone imbalances. There is no reason to suffer from the symptoms, they say.
Relief can take time, added Dr. Brust, “but if BHRT is the right path for you, most will notice a difference in the symptoms that bothered you quickly, and you will start to feel better.”
For McKiernan, that meant a better and more fulfilling life. “I have energy. I think clearly. I have emotions now,” she said. “My mom says the old Tonya is back.”