Bio-identical Hormones for Aging Men

 

Bio-identical Hormones for Aging Men

Patricia Ryan, MD, CCN

Men go through andropause. Their testosterone production goes down as they age.  In my experience, it varies as to when this starts happening in each individual.

     There are many possible causes of diminished testosterone production in men.  Heavy metals such as lead, cadmium, mercury and other toxic metals interfere with testosterone synthesis.  Prolonged stress will decrease testosterone output. The body actually produces cholesterol and then converts it into the hormones it needs. Low cholesterol from over aggressive treatment with cholesterol lowering drugs such as Statin drugs will also lower testosterone levels.  Testosterone replacement is an important option for many men as they look at maintaining their health.

     Some groundbreaking research done by a Harvard Urologist by the name of Dr. Abraham Morgentaler, MD revealed that men who have low levels of testosterone have a 14% increased incidence of prostate cancer.  He tested men’s testosterone levels.  When they were low, he biopsied their prostate gland and found a higher incidence of cancer.  This was important because it went against what was prior “dogma” that testosterone was a cause of prostate cancer.  Low testosterone is actually a risk factor for prostate cancer!

     If a man chooses to take testosterone replacement therapy, he needs to be monitored properly. Testosterone and some of the metabolites of testosterone should fall in the normal range.  We routinely monitor the estradiol and di-hydrotestosterone (DHT) levels.  There is some new testing that is being evaluated to fine-tune this information even further.  As we get more information on this, we will offer this testing to our patients.

     Benign Prostatic Hyperplasia is very common in men as they age.  There are a few nutrients that are helpful in slowing this process down.  These include essential fatty acids, zinc, saw palmetto, beta-sitosterol, quercitin, and lycopene.  Diet is particularly important.  Limiting red meat, increasing vegetables (greatly), and decreasing simple carbohydrates are essential steps to slowing down the process of prostate enlargement.

   In addition to testosterone, there are several nutritional interventions that may be helpful for men experiencing erectile dysfunction.  Acetyl-l-carnitine, testosterone, and propionyl-l-carnitine have improved all outcomes of male aging and erectile dysfunction. They were also more powerful than Viagra alone or improved Viagra’s effectiveness after radical prostate surgery.  Addressing blood flow issues (vascular disease) helps penile blood flow as well.  Some supplements that address vascular health include pycogenol, l-arginine, vitamin B6, and vitamin B12.

For more information we recommend attending our monthly seminar “Introduction to Functional Medicine”. Bio-Identical Hormone Replacement for both men and women is covered in the seminar. You can register for the seminar online here.  We also recommend the book “Testosterone For Life” by Dr. Morgentaler, which is available to purchase at Alternatives. If you have additional questions please call us at 402-827-9450 or email alternativesomaha@gmail.com.

Truth in Hormone Research

Truth in Hormone Research

From Alternatives Newsletter Spring 2009

With all the controversy about hormone replacement therapy, what should women believe?  "A lot of women are scared of hormones; they don't know what to think," said Dr. Patricia Ryan, founder of Alternatives: A Center for Conscious Health.  "With all of the studies about the subject, it's no wonder the topic is so confusing for so many," she said.

"The problem is, studies that link hormone usage to increased cancer risk are often addressing synthetic hormones," Dr. Ryan said.   "And women should, in fact, stay away from those synthetic hormones.  Bioidentical hormones, on the other hand, replicate the progesterone and estradiol that the body produces.  That's why, if you see a study that says hormones cause cancer, you need to look for the names of the hormones that have been researched.  Unless they are estradiol and progesterone, they are in fact synthetic hormones that most likely could increase the risk of cancer."

According to Dr. Ryan, plant-based bioidentical hormones are the exact molecular composition of those estradiol and progesterone hormones that the body produces.  "A picture, in fact, is worth a thousand words," Dr. Ryan noted.  "If you compare the molecular structure of a synthetic hormone with one produced by the body or replicated by bioidentical hormones, you will see a vast difference.  Not all hormones are alike."


Molecular structure of a "Bio-identical Estrogen" (above) compared to a "Synthetic Estrogen" (below)

Note the differences in the Progesterone molecules...

Molecular structure of a "Bio-identical Progesterone" (above) compared to a "Synthetic Progesterone" (below)

Hormone deficiency in post-menopausal women can lead to serious problems, both physically and emotionally, Dr. Ryan said.  "Some women might develop osteoporosis or see their cholesterol skyrocket.  Others might become so mean that their husbands want to divorce them, or they can't sleep or keep their jobs because they can't remember.  Still others gain weight they can't seem to lose.  When hormones are depleted, insulin levels go up.  That can lead to an increased risk of hypertension, heart disease, cancer and diabetes.  What are your choices as you age?  You can wait until your body falls apart or you can be proactive," Dr. Ryan said.

In administering bioidentical hormones, Dr. Ryan uses biomimetic estradiol and progesterone in a topical cream preparation -- dosed to mimic the natural hormones produced by your body when you were 25 years old.

For more information about bioidentical hormones, contact the Alternatives clinic at 827-9450, also visit The Wiley Protocol for BHRT website

Hormones Play Key Role in Osteoporosis

Under Construction:

Your Bone’s Remodeling Efforts Need Good Nutrition, Calcium and Vitamin D 

From Alternatives Newsletter November 2006

Most people don’t think of their body as a construction zone, but the truth is that bones are in a constant state of remodeling, said Dr. Robert Heaney, a Creighton University professor and one of the nation’s leading authorities on osteoporosis.

“Bones turn over 10 percent each year – they’re constantly replacing bony structures,” Dr. Heaney said.  “One of the principal reasons that bones become fragile is not simply because bone mass is low, but because the remodeling rate is high.  If a bone is flimsy and someone has lost part of that bone and at the same time they’re doing a lot of remodeling, the structures that are needed for support may be out of commission.”

And that, Dr. Heaney said, is often how osteoporosis develops and does its damage.  Osteoporosis is a disease in which bones become fragile and more likely to break.  Left untreated, osteoporosis progresses painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine and wrist, according to the National Osteoporosis Foundation.  Of the 10 million Americans who suffer from osteoporosis, women are four times more likely than men to develop the disease.

Dr. Heaney said that this potentially debilitating condition can be caused by many factors including lack of exercise, hormone deficiencies, heredity, vitamin D deficiency, certain medications, and too little calcium.  “What can happen with someone who does not have enough calcium and vitamin D is that the body then tries to compensate by taking calcium out of the bones,” Dr. Heaney said.

Solid nutritional intake is the first line of defense to protect against osteoporosis, Dr. Heaney said.  “Good nutrition is the key,” he said.  “Bones require adequate calcium, vitamin D, protein, phosphorus and magnesium.  Making good food choices is vital, with dairy being one of the best to prevent osteoporosis,” he said.  A bone density scan used to diagnose low bone mass and osteoporosis can be valuable at any time when you’re starting to tune in to the importance of strong bones.  “Then the results will be motivating to you,” Dr. Heaney added.

For more information about osteoporosis, visit the National Osteoporosis Foundation Web site at www.nof.org or contact Dr. Heaney at rheaney@creighton.edu.

Hormones Play Key Role in Osteoporosis

Menopause for women seems to play an important role in the development of osteoporosis, suggesting that a decrease in the hormone estrogen may explain why women appear to be more vulnerable to the disease than men, according to Dr. Patricia Ryan, founder of Alternatives: A Center of Conscious Health.

“We know that estrogen starts to shut down for many women around the age of 50, while testosterone is declining for men much more slowly.  When men’s testosterone levels become depleted, they are also at higher risk for osteoporosis,” Dr. Ryan added.

Recent scientific studies have helped to substantiate the connection between osteoporosis and hormones.  British scientists experimenting with mice believe they may have found why post-menopausal women often suffer from osteoporosis, according to findings reported in 2003.

The researchers discovered that mice lacking a key estrogen-regulating protein were unable to grow enough bone cells.  The research was expected to lead to new therapies to treat osteoporosis in post-menopausal women.

“As Dr. Heaney explained, good nutrition is so important to stop the progression toward osteoporosis,” Dr. Ryan said.  “So is avoiding sugar and alcohol, which can serve to deplete calcium from the bone as well as to upset the body’s healthy ph balance.  Balancing hormones through the addition of bioidentical hormones also can help some women prevent osteoporosis.”

In addition to bone density scans, Dr. Ryan said a urine test – the pyridinium crosslinks urine test – is available to help detect whether the body is losing bone mass.

For more information about osteoporosis, contact Dr. Ryan at Alternatives: A Center for Conscious Health at 827-9450 or visit www.centerforconscioushealth.com

Bioidentical Hormones: Managing change

Bioidentical Hormones:  Managing change

From Alternatives Newsletter April 2006

Fluctuating hormones are a natural part of aging.  But the physical, mental and emotional upheavals that come with “the change” in life often wreak havoc that interferes with daily living for thousands of women.  What’s worse, these symptoms – there are up to 35 – can last for years.  Hot flashes, mood swings, irregular and painful periods, yeast and urinary tract infections, afflict many women during this time of life.
Menopause is defined as the stage in life when a woman has not had her menstrual cycle for one year.  But many of the most troublesome symptoms of this change actually occur in peri-menopause, a transitional stage of two to ten years before menopause when hormones are fluctuating wildly.
“Research has shown that only about 20 percent of women survive menopause with no symptoms,” said Dr. Patricia Ryan.  “The rest experience problems that range from mild to severe.  Some women manage these changes with diet and exercise.  There are also various herbs, such as chasteberry and black cohosh, which can help,” she added.
“But as hormones wane, many women will feel better only by re-balancing their hormonal systems.  And the best way to do that is through bio-identical hormones,” Ryan said.  “Bio-identical hormones have the same molecular structure as the hormones made by a woman’s body.  Interest in bio-identical hormones surged when research conducted through the Women’s Health Initiative showed that synthetic hormones may carry health drawbacks, including cancer risks,” Dr. Ryan said.
To prescribe bio-identical hormones, levels in a woman are tested and then precise dosages of bio-identical estrogen, progesterone, testosterone and/or DHEA are written to meet that woman’s individual needs.  For more information about bio-identical hormones, contact Dr. Patricia Ryan.

Omaha woman:  Back in balance

Sonya Crane, an Omaha mother of three with a background in human development, had always been healthy.  Suddenly, at age 39, she was plagued with a number of disturbing symptoms such as severe memory loss and muscle weakness, fatigue, anxiety and insomnia.  “I’d forget to pick up my daughter,” she said.  A former track athlete, Sonya had trouble walking up a flight of stairs.  “When it came to cooking, all I had energy to do was boil water,” she added.  A doctor referred her to a neurologist to rule out Multiple Sclerosis.  And Sonya thought she might have cancer because she was so weak. 

Several rounds of blood tests didn’t identify the problem.  However, one test showed that the estrogen in her system was abnormally low for her age.  Knowing the importance of hormones, Sonya tried to convince her doctors to conduct more tests, but they wouldn’t agree.  After all, she was only 39, younger than the normal onset of menopause.

So Sonya arranged for the tests herself.  “I spent $650 on a hormone test through a pharmacy,” she said, “and found out my testosterone, progesterone and estrogen levels were all too low.”

Doctors offered mood stabilizers and sleeping pills.   Sonya opted for hormones, but not the synthetic variety many doctors prescribe.  Instead, she requested bio-identical hormones as a solution to balance her system, because she felt they would more closely mimic her body’s own hormonal make-up.

“By the third day on bio-identical hormones, I was back to my old self again.  I was cooking and baking, and my house was clean.  All my symptoms went away and I feel much happier, more patient and loving towards my children and husband – not to mention having the energy to care for my family, which has always been the highlight of my life!  I’m speaking out because I’m a woman’s and family advocate and if a woman loses her health, she’s unable to care for her family and be loving to her husband.  That’s why women should find doctors who are willing to prescribe optimal levels of bio-identical hormones.”  

Sonya said that Dr. Ryan will continue to monitor her hormone levels to help her achieve optimal balance.  For more information about bio-identical hormones, contact Dr. Patricia Ryan, a professional preventative medicine doctor.