Bio-identical hormone replacement therapy (BHRT) is comprised of the same chemical structure as hormones naturally made in the human body. Because bio-identical hormones are metabolized the same way as our own hormones, their use creates no unpleasant side effects or harm to our bodies. Hormone supplementation becomes necessary because our bodies decrease hormone production as we get older. Signs that this has occurred include depression, overall fatigue, mental confusion, low libido, and increased visceral fat. BHRT supplementation is the safest and most natural way to restore balance and health. This can include sublingual troches, oral tablets and transdermal creams and gels.
Estradiol is the primary estrogen hormone, as such it metabolizes into estriol and estrone. As the most potent estrogen, estradiol provides beneficial effects associated with the estrogens. Primarily secreted by the ovaries, estrogens help protect against such diseases as Alzheimer’s disease, stroke, heart disease, and osteoporosis. In addition, estrogens also help to protect against and to treat vaginal atrophy and incontinence. When estrogen is depleted, such symptoms as depression, mood swings, fatigue, decreased skin elasticity and urogenital atrophy, which causes incontinence, occur. Multiple studies have shown that when bio-identical estrogen is used for supplementation it has better outcomes and fewer side effects than synthetic estrogens.
Progesterone is secreted by the ovaries, like estradiol, and is equally important as estradiol in both perimenopausal and menopausal women. During perimenopause, women often suffer from abdominal cramping, headaches, difficulty sleeping, irregular periods, and mood changes. This is caused by progesterone levels surging up to 400 or 500 before dropping. Like estradiol, progesterone protects against osteoporosis, uterine and breast cancers, ovarian cysts, coronary artery disease, and fibrocystic disease. Because there are progesterone receptor sites in the breast, vagina, uterus, blood vessels, and brain, all of these organs and vessels benefit from progesterone supplementation.
DHEA is produced in the adrenal glands and is an endocrine precursor for the synthesis of testosterone, estrone and estradiol. DHEA levels decrease with age at a constant rate each year. This results in central obesity, insulin resistance present in type 2 diabetes and metabolic syndrome. Vital in stimulating the immune system, in addition to decreasing cholesterol and body fat, DHEA is also cardio-protective because it decreases tumor necrosis factor, which causes inflammation within the arteries, which leads to atherosclerosis. Because it is an endocrine precursor to other hormones, DHEA works as a preventative treatment for heart disease, diabetes, and osteoporosis.
Testosterone is produced in both men and women. It serves to enhance mental health and clarity of thought. Along with other hormones, testosterone decreases with age, which leads to fatigue, poor muscle tone, endurance, and depression. In both genders testosterone works to improve sexual performance, libido, bone density, and lean muscle mass. As studies have shown, the supplementation of testosterone produces significant results in reducing all over body fat, increased bone density, muscle strength, and lean muscle mass. Testosterone also improves healing, skin tone, and hyperlipidemia.
Thyroid glands produce both T4 and T3 hormones. T4 converts into T3, the active hormone that controls energy levels and metabolism. Low levels of T4 and T3 indicate an underactive thyroid. Symptoms include fatigue, weight gain, constipation, dry skin, hair loss or thinning, and difficulty concentrating. To maximize the beneficial effects of thyroid hormones, The Steelman Clinic strives to obtain optimal levels in T4 and T3, as well as various other hormones.
Melatonin determines our wake-and-sleep cycle. It is an endogenous hormone that works to maintain our natural circadian rhythm. As with so many other hormones, the production of melatonin decreases as we age. Supplementing melatonin not only improves sleep patterns, but also the depth and quality of sleep.
Further Information on Testosterone
A sex hormone found in humans and vertebrates, testosterone is a naturally occurring androgen (male hormone) produced by the testes in men and the ovaries in women. There’s around ten times more testosterone in men than in women. It is the most potent circulating hormone of the naturally occurring androgens. For men, testosterone is vitally important for overall health and wellness. Unfortunately, however, this hormone begins decreasing after age 40 and these lowered levels cause all the effects of aging. Multiple studies over the last few decades have dramatically demonstrated that low levels of testosterone are detrimental to men’s health, because testosterone is much more than a sex hormone, it provides such non-sexual health benefits as:
Cardiovascular Function – Testosterone levels are directly related to heart and vascular health. Evidence suggests that low levels of testosterone in men are associated with an increased risk of cardiovascular disease in men. This is due in part because testosterone lowers total cholesterol and triglycerides in most men, which decreases the risk of heart attack and strokes. At The Steelman Clinic we’ve witnessed these same results with our patients. Statin drugs, which are also often used to lower cholesterol, have potentially harmful side effects not shared by testosterone.
Muscle Function – Testosterone increases lean muscle mass and strength. It also increases endurance and exercise ability. When used properly, testosterone achieves optimum physiological levels by increasing lean muscle mass, thereby improving body composition. Testosterone also improves stamina for such athletic activities as biking, running, swimming, cross training, and golfing.
Brain Function – Psychological stability and a sense of well-being are both enhanced by testosterone. In addition, memory is improved. Testosterone prevents depression and also helps to prevent Alzheimer’s disease and dementia. Receptors in the brain rely on testosterone for short term memory, mood stabilization, mental clarity, and cognitive performance.
Sexual Function – The primary male hormone, testosterone is responsible for erections, orgasm, sexual desire, sensitivity, performance, and satisfaction. Studies have shown that the more satisfying the sexual relationship a married couple has, the longer and happier their lives will be. Until recently, it was considered normal for sexual activity to decrease as we age. We now know that doesn’t have to be the norm. By raising testosterone levels, sexual function is restored. Despite what drug manufacturer commercials claim, erectile dysfunction is best restored by raising testosterone levels.
Prostate Function – The medical establishment wrongly believed for decades that testosterone replacement therapy increased the risk of prostate cancer. Recent studies have shown that not only does testosterone not cause prostate cancer; it doesn’t even increase the risk of prostate cancer. After all, prostate cancer is almost never seen in the peak testosterone years, the early 20s. There is, however, an increased risk of prostate cancer in aging men with low testosterone. A study from Harvard Medical School found that testosterone replacement therapy is even safe for men who had prostatic precancerous lesions. The prostate actually needs testosterone to function properly.
Endocrine Function – The more testosterone found in a body, the less fat that body will have. Testosterone reduces visceral fat. In fact, testosterone therapy can reduce intra-abdominal obesity and improve insulin concentrations in older men. It also reduces insulin resistance and improves glycemic control in men who have Type 2 diabetes.
Bone Function – Testosterone increases bone mineral density. As the body grows older, testosterone levels lower. When this happens, adipose tissue (fat) begins to replace muscle mass and osteoporosis and osteopenia begins to occur. Studies have shown that more than 40% of men over age 65 die within 12 months of suffering a fractured hip. When a man in his 60’s – 90’s falls, bone density often determines whether he’ll have a bruised hip or a fractured hip.
Testosterone also has a huge impact on . . .
How men feel – When low testosterone levels are raised through testosterone replacement therapy, motivation, vigor, stamina, energy, and a sense of well-being return. Quality-of-life studies have shown that men with low testosterone levels who receive testosterone replacement therapy, report more of a feeling of well-being than men with low testosterone levels who did not choose testosterone replacement therapy. Testosterone levels drop gradually over the years. Therefore, most men notice subtle changes over time, but have difficulty pinpointing why they don’t feel as good as they once did. These are just a few of the symptoms that can come from having low testosterone levels.
Medical concerns associated with testosterone treatment
Sometimes when testosterone treatment is given, acne can occur. This depends on the dose and subsides when the amount given is lowered. In rare cases, male breast enlargement occurs. This also regresses when the dose is reduced. In addition, there can be a slight increase in red blood cell count with testosterone replacement, but this is benign. The medical term for this is erythrocytosis, which is sometimes confused with a blood disorder known as Polycythemia Vera, but they are not the same.
Most labs consider normal testosterone levels for all males between 10 – 90 years of age to range from 300ng/dl to 1000ng/dl
The members of the American Endocrine Society and The Second Andropause Consensus Panel consider 250ng/dl very low, 400ng/dl low and 500ng/dl borderline low.
Most males are at their peak fitness when their testosterone range is 700ng/dl – 800ng/dl.
Testosterone replacement therapy
Two types of testosterone are used to restore testosterone levels: bio-identical testosterone and synthetic testosterone. Bio-identical testosterone has the same chemical and molecular structure as the testosterone produced by the body. Since it is metabolized by the normal metabolic pathways of the body, bio-identical testosterone is safe and doesn’t produce harmful metabolites. Synthetic testosterone, on the other hand, should never be confused with bio-identical testosterone. Synthetic hormones are made because they can be patented and therefore sold at a high profit. Because they aren’t identical to the testosterone created by the human body, they are far more likely to have side effects. These can include: an increase in blood pressure, aggression, insomnia, and liver and kidney disease.
Testosterone replacement methods
A variety of methods can be used for testosterone replacement: injections, patches, gels, creams, oral tablets, sublingual torches, and subcutaneous pellets. There are potential issues with all these methods. Injections hurt and, because they’re given all at once, have a roller-coaster effect. Patches aren’t user friendly. Creams and gels have to be applied once or twice a day. Taking testosterone orally can be harmful to the liver. Plus, pellets are surgically inserted under the skin. Naturally, it’s far more convenient when the body produces its own testosterone, but once that level is lowered it’s detrimental to one’s health to not replace testosterone to its optimal levels.
At The Steelman Clinic, we prefer two methods: transdermal cream and subcutaneous pellets. The transdermal cream is applied twice a day and supplies a steady dose of testosterone . . . as long as the cream is actually applied twice a day, every day. When pellets are used, nothing is required of the patient once they have been implanted. The pellets deliver a steady dose of testosterone for 4 – 6 months. After that, more must be implanted.
The beneficial effects of maintaining optimal testosterone levels have been discussed and demonstrated in medical literature worldwide. For that reason and others, we anticipate having the ability within the next ten years to monitor testosterone levels in much the same way we’re now able to monitor lipid and glucose levels. There’s no question that low testosterone levels are a precursor to disease and increased mortality. At The Steelman Clinic we consider maintaining an optimal level of testosterone of vital importance for men’s health. We believe men in their 40’s to 90’s should watch their testosterone levels and know when they are low. When those levels are low, we highly recommend testosterone replacement therapy, using either bio-identical testosterone transdermal cream or subcutaneous pellets.