Positive Health Online

Hormones orchestrate complex messages throughout the body. They can interact, block and enhance many facets of endocrine function. As a result, their excesses, deficiencies and imbalances can have marked impacts across physical, mental and emotional aspects of health. A tiny fraction of the evidence of their diversity of effect is appended.[1-7]

Hormone imbalances can manifest in a multitude of ways but these health problems are not merely the result of a deficiency or an excess of one particular hormone. There are many factors that contribute to dis-ease, but where hormonal involvement is suspected, imbalances can be a place to start because they can also have a major impact on the person’s experience of a health problem. Let’s examine the case of ‘Siobhan’, a 37-year-old woman with a regular but heavy period, experiencing severe symptoms:
Physical: tender breasts, cold body temperature, fatigue, aches and pains, headaches, disturbed sleep, decreased libido, decreased stamina and constipation.
Mental and Emotional: depression, stress, mood swings, nervousness, irritability and anxiety.

Siobhan had been to a number of different practitioners for help and had arrived at Bio-Vitality out of desperation; things were getting worse, not better. According to Siobhan, her practitioners seemed to home in on her age and her symptoms of mood swings, heavy periods, loss of libido and tender breasts as being signs of oestrogen dominance. She was prescribed a series of herbal mixtures that contained phyto-hormones, especially those that contain progesterone-like substances (there are believed to be over 5000 such plants). When symptoms did not relent, prescriptions were changed, but things were still going the wrong way.

The results of Siobhan’s saliva assay showed a normal range oestradiol, testosterone and DHEAS, but extremely high progesterone and quite high morning cortisol.

Siobhan’s main problems were:
Excess progesterone, which was causing or contributing to, for example, her:

• Lowered libido – it blocks the conversion of testosterone;
• Depression – it interferes with serotonin production;
• Constipation – it can slow the food transit process.

Also, over time, excess progesterone may convert to deoxycorticosterone, which could explain Siobhan’s breast heaviness/tenderness and the fatigue. This can also happen with high cortisol levels.

Excess cortisol would be confusing the picture further. This illustrates how hormonal imbalances can be deceptive because they can give mixed messages, they can be inhibited by nutritional deficiencies or environmental toxins and they can be blocked from a cell receptor that is occupied by cortisol, for example. These types of problem are not just limited to the obvious sex hormone connections either: Inflammatory Bowel Disease can induce high levels of cortisol and lead to symptoms of oestrogen dominance: tender breasts, water retention, bloating and mood swings amongst other things, which only add to the stress of the condition.

It is probable that Siobhan was initially suffering from oestrogen dominance, which was compounded by high cortisol levels (the symptoms of oestrogen dominance are difficult to live with). However, through blind supplementation, her practitioners were not aware that the initial attempts were being thwarted by possible high cortisol levels, and over-prescribed, ultimately making imbalances worse.

In order to aid with the return of Siobhan’s hormone balance the following protocol was recommended:

A brief lifestyle audit to assess areas of stress and to devise better coping strategies as well as schedule time for activities such as: yoga, meditation, Reiki or massage. It has to be something that appeals to Siobhan and that will fit in with her lifestyle, and not add further stress!

A Nutritionist would be able to help with local assessment and guidance with her diet. Supplements – an approach to support a return to balance.

• A gentle, short-term phytoestrogen therapy to counteract the excess of progesterone;
• Adrenal support, which should contain vitamin B5 (pantothenic acid) as well as botanicals such as Siberian ginseng, Rhodiola and cordyceps;
• Further nutritional support in the form of a good multi-formulation that includes vitamins, minerals and trace elements in highly bio-available forms;
• A comprehensive liver support that will enhance function in detoxification processes and enzymatic pathways. This may contain: milk thistle, N-Acetyl-L-Cysteine, Alpha-Lipoic, L-Methionine, L-Cysteine, Taurine and Trimethylglycine.

Through the good multi-formulation adequate intake of vitamin C, B vitamins and selenium are also ensured for the benefit of the liver function and to help with the impacts of these hormonal imbalances on the adrenal and thyroid glands too.

This is just an immediate protocol to regain a better quality of life. Further issues undoubtedly remain, such as the impact on her bone health through high levels of cortisol and imbalanced oestrogen and progesterone. There may be stubborn areas such as the depression that may need additional thought and observance – there can be psychological issues that require good counselling. Aside from all that, as a 37 year old woman with heavy periods, it would be worth confirming, through clinical examination by her doctor, if fibroids are present, as if they are, her previous treatment plans would have exacerbated growth and this should be taken into account with her ongoing hormone strategy.

The best way to ascertain a real picture of hormonal imbalance is the correlation of recognized symptoms with clinical quality results in order to put your results into a context. It is also very important to have an accurate picture, and the best way of achieving this is through the testing of ‘free’ or active hormone levels which only constitute between 1-5% of total hormone levels tested in blood serum. Total levels can be deceptive because, for example, an excess of oestradiol will stimulate higher production of Sex Hormone Binding Globulin (SHBG), which reduces the bio-availability of testosterone. This is an irony of being on the Pill, as many women have much higher levels of SHBG and report a resultant loss of libido![8]

Evaluating the hormonal picture with accurate symptom reporting across appropriate physical, mental and emotional aspects of health will empower any practice whether medical or CAM. A hormone balancing approach provides a tool to promote patient/client education, improve compliance and self-responsibility and ultimately improve outcomes.

As for Siobhan, the natural approach to her specific hormone imbalances was followed, and within a short period of time she reported not only that she felt like her ‘old self’ again, but that her husband and children had commented on how good it was to have Mummy back. She had stuck with the protocol because she could understand for herself why things were not right and felt that what was recommended was based on strong evidence and not ‘just’ whether she trusted her practitioner enough to follow it through. The written report accompanying her clinical quality results allowed her to refer to it as often as she wanted and this supported her journey through hormone imbalance to resolution.

References

1.    Sareen J et al. Disability and Poor Quality of Life Associated with Comorbid Anxiety Disorders and Physical Conditions. Arch Intern Med. 166: 2109-2116. 2006.
2.    Chen et al. Dose and Temporal Pattern of Estrogen Exposure Determines Neuroprotective Outcome in Hippocampal Neurons: Therapeutic Implications. Endocrinology. 147: 5303-5313 published online before print as doi:10.1210/en.2006-0495. 2006.
3.    Green K et al. Glucocorticoids Increase Amyloid and Tau Pathology in a Mouse Model of Alzheimer’s Disease. J Neurosci. 26: 9047-9056; Doi:10.1523/JNEUROSCI.2797-06. 2006.
4.    Crandall C et al. Association of New-Onset Breast Discomfort With an Increase in Mammographic Density During Hormone Therapy. Arch Intern Med. 166:1578-1584. 2006.
5.    Guimaraes P et al. Progestin negatively affects hearing in aged women. PNAS. 103: 14246-14249; published online before print as 10.1073/pnas.0606891103
6.    Janowsky J. Women on Hormone Therapy Regain Emotion Response. Oregon Health and Science University Press Release. 16.10.2006.
7.    Kornstein S et al. Low Doses of Anti-Depressant May Spell Relief for Some Women Suffering from Mild-to-Moderate PMS. Virginia Commonwealth University Press Release. 13.10.06.
8.    Panzer C et al. Impact of Oral Contraceptives on Sex Hormone-Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction. Journal of Sexual Medicine. 3: 104-113. 2006.

Further Information

Bio-Vitality has a CPD Approved Hormone Masterclass for CAM practitioners, which includes your own hormone testing. Tel: 01481 258225; 020-77193 6460; admin@bio-vitality.com www.bio-vitality.com