Natural Hormones: Theory and Practice

One of the greatest areas of confusion in complementary medicine today is the subject of natural hormones. Consumers, practitioners, educators, manufacturers and the media all contribute to the misinformation and misunderstanding. This article will attempt to clarify this topic as well as explain the functions hormones play in our health.

What is a hormone?

Hormones are chemical messengers produced by a variety of glands and organs in the body. Hormones course throughout the blood stream and enter cells and tissues where they turn on and off various functions. Most responsible for hormone control and production are the pituitary gland, hypothalamus, pineal gland, thyroid gland, adrenals, pancreas, ovaries and testes.

Steroid Hormones

Some hormones are composed of large proteins and others of small fatty substances derived from cholesterol. One class derived from cholesterol belongs to a family of hormones termed steroids. The steroid family is broken down into six major categories as follows:

Cholesterol -> pregnenolone -> progestagens -> androgens -> estrogens
-> glucocorticoids
-> mineralocorticoids

Cholesterol is converted to the mother steroid hormone pregnenolone, which is further converted in the ovaries, testes and adrenals to other hormones as directed from protein hormone signals from the brain.

What Function Do Hormones Provide?

Pregnenolone
-is produced in the adrenal glands and also in the brain, liver, ovaries, testes and nerve myelin sheath
-other hormones such as DHEA, cortisol, progesterone, testosterone and estrogens are made from pregnenolone
-known to enhance mood, energy and memory

Estrogens (estradiol, estrone, estriol)

-refers to a group of hormones not just one
-is required for the female secondary sex characteristics and menstrual cycle
-estradiol is the most potent estrogen and is most stimulating to the breast tissue and is made mainly in the ovaries

-estrone is most prevalent after menopause and is produced by the adrenal glands and fat cells
-estriol is made during pregnancy and is thought to be the main circulating estrogen in young women; estriol is made from estrone and estradiol and is the least stimulating to breast tissue
-excessive estrogens can cause fluid retention, weight gain, migraines and over stimulation of the breasts, ovaries and uterus, leading to cancer
-insufficient estrogen levels can lead to hot flushes, vaginal dryness, rapid skin aging, urinary problems and excessive bone loss
-an excess of estrogen, relative to testosterone, is thought to play a role in the development of prostate problems, including cancer, in men

Progestagens (progesterone)

-prepares the lining of the uterus for implantation of an ovum and for the maintenance of pregnancy
-is produced in the ovary just prior to and after ovulation
-also made in large quantities by the placenta during pregnancy and in small amounts by the adrenal glands
-progesterone enhances estrogen activity while also moderating symptoms of estrogen excess such as water retention, fat accumulation, uterine bleeding and mood swings
-helps promote thyroid function and may also stimulate cells needed for bone building
-it appears that it may be important in men for the maintenance of prostate health
-progestin is the term applied for the synthetic derivatives of the natural hormone, progesterone

Androgens (testosterone, DHEA, androstenedione)

-responsible for the development of male secondary sex characteristics
-in men is mainly produced by the testes, and in smaller amounts by the adrenals; women produce testosterone in both the ovaries and adrenal glands
-is involved in the maintenance of lean body mass, bone density, skin elasticity, sex drive and cardiovascular health in both sexes
-men make more of this hormone, accounting for their greater bone and muscle mass
-DHEA is the principal androgen is both men and women and levels decline with age
-once DHEA enters the cells it may be converted to testosterone and estrogens
-DHEA supplementation can restore energy, improve immune function, lift depression and improve mental function
-androstenedione is a precursor for both estrogens and testosterone, especially in females
-it can be produced in excess by the ovaries during menopause and can cause women to lose scalp hair and grow facial hair

Glucocorticoids (cortisol, hydrocortisone)

-promote sugar, fat and protein metabolism
-produced in the adrenal glands and play an essential role in immune function, fighting inflammation, defence against infection, and responding to stressors such as emotional upheaval, exercise, surgery, illness and starvation
-cortisol levels are highest in the morning, to combat the stress of overnight fasting and to prepare the body for the day’s activities

Mineralocorticoids (aldosterone)

– affect kidney function, which in turn controls blood pressure and blood volume
-produced by the adrenal glands

“Natural hormones” are generally defined as those hormone medications that are biochemically and molecularly identical to the human hormone form and have been derived from plant sources. The two plants utilized in this process are soybeans and Mexican wild yam. Plant derived biochemically identical hormones can be made from either plant. With soybeans, beta-sitosterol is extracted and then with various laboratory enzymatic reactions, a hormone is made. With Mexican wild yam, diosgenin is extracted and in the manufacturing laboratory the same hormones can be made.

What is the difference between a natural hormone and conventional hormone replacement such as conjugated equine estrogens (Premarin) or synthetic hormone such as medroxy progesterone acetate (Provera)? Natural hormones are biochemically identical to ours and match the hormone molecules produced by our own glands. Synthetic hormones or hormones from the urine of pregnant mares are not the same hormone molecules as ours. They don’t match and are not natural to what our body is familiar with. The arguable contention is that this difference contributes to some of the short term and long-term problems of conventional HRT. The assertion further goes that women may metabolize these foreign hormones differently, taxing their metabolic pathways and producing more harmful metabolites and interactions with their own physiology. Foreign hormones may be excreted more slowly, and by lingering in the body longer, they may have an opportunity to effect receptor sites in a negative way. In clinical practice, women by and large tolerate natural hormones better than the synthetic counterparts.

One natural hormone medicine commonly used is topical progesterone cream. Here is another maze of confusion. There are basically two categories of creams on the market–ones that contain only wild yam and no progesterone and ones that contain the actual progesterone converted from diosgenin. Unfortunately, manufacturers are not always clear about into which category their cream falls and the strength of their cream, if indeed it does contain progesterone. Absorption of progesterone via the skin is variable from person to person and further study is required to understand its reliable use. Oral micronized natural progesterone is able to deliver suitable pharmacological levels but is available only by a licensed physician.

There are three dominant estrogens in the body: estriol, estradiol and estrone. They are different from each other. Holistic doctors through compounding pharmacies (pharmacies that custom make drug preparations in a variety of forms and strengths) can prescribe a combination of these estrogens to produce what is referred to as a “friendlier” hormone. The theory is that these custom preparations are safer, more pure and closer to the natural form used and produced by the body. A current practice is for a tri-estrogen compound to be composed of 80% estriol, 10% estradiol and 10% estrone. This is based on a laboratory determination made by Dr. Jonathon Wright, MD who has claimed that this is the normal physiologic proportion. There is some question as to the basis of this formulation and further study is required to determine the accuracy of these percentages.

More and more doctors are realizing the importance of testosterone and DHEA in both men’s and women’s health. Improvement in sex drive, bone health, sense of well-being and menopausal signs and symptoms have been documented.

Safety of Natural Hormones

Natural hormones theoretically should be safer than the synthetic counterparts. Many practitioners strongly believe this and some will vouch for this through both clinical and statistical data. Many deem that the cancer risk is much reduced with these types of medications versus the conventional ones. However, there are conflicting results from a variety of sources that ascertain an opposite point of view. My current position is that if you don’t need to take hormones, don’t. If other lifestyle, nutritional or herbal alternatives work for you (written about extensively in previous Alive issues), then use them. If these alternatives are not satisfactory, than certainly natural hormones make sense.

Natural hormones deserve more attention and research. Women and men want them and they offer not only a potentially safer alternative but also one with many more options for individualized dosing and formulations to meet the unique needs of each person.

 

Copyright © 2003 by Dr. Garrett G. Swetlikoff

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