Bio-identical hormones have the same chemical structure as hormones that are made by the human body. The key to natural or No-identical versus synthetic is the molecular structure of the hormone. In order for a replacement hormone to fully replicate the function of hormones which were originally naturally produced and present in the human body, the chemical structure must exactly match the original.

Researchers have long held that there are significant differences between hormones that are natural to humans (bio-identical) and synthetic (including animal-derived) preparations. Structural differences that exist between synthetic or animal and human hormones may be responsible for side effects that are experienced when non-bio-identical hormones are used for replacement therapy.

Side chains may be added to a natural substance to create a synthetic product that can be patented by a manufacturer. A patented drug can be profitable to mass produce, and therefore a drug company can afford to fund research as to the medication’s use and effectiveness. However, bio-identical substances can not be patented, so scientific studies are less numerous on these natural hormones.

Goals of Bio-Identical HRT

ü      Alleviate the symptoms caused by the natural decrease in production of hormones by the body

ü      Give the protective benefits which were originally provided by naturally occurring hormones

ü      Re-establish a hormonal balance

The goal of any form of Hormone Replacement Therapy (HRT) should be to provide an adequate supply of the deficient hormone in a form that is as close as possible to that which the body originally produced, therefore resulting in normal physiologic effects. Every person is unique. Therefore, it is a sensible approach for health care professionals and patients to work together to customize HRT Bio-identical HRT can be compounded in the needed strength and dosage form and administered via the most appropriate route to meet each individual’s needs.

The precise components of each person’s therapy need to be determined after physical examination, medical history, symptoms, and laboratory testing are considered. Close monitoring is essential to ensure that appropriate dosage adjustments are made.

Bio-Identical HRT for women

Estrogens

ü      are a group of related hormones, each with a unique profile of activity. The three principle estrogens in human females are Estriol (E3), Estradiol (E2) and Estrone (El).

ü      are often prescribed in combination to re-establish a normal physiologic balance. The use of one or more of these hormones is referred to as Estrogen Replacement Therapy (ERT).

Bio-identical estrogens have been shown to be clinically effective

ü      for the treatment of menopausal symptoms.

ü      for the treatment of postmenopausal problems including vaginal atrophy, dryness, or infections, painful intercourse, and various conditions of the urinary tract.

ü      in decreasing the risk of osteoporosis and colorectal cancer.

Despite studies reporting the risks associated with synthetic hormones, conjugated equine estrogens remain the most frequently prescribed form of ERT. Published clinical trials have reported that the risk of breast cancer is increased by long-term use of conjugated equine estrogens and further increases when the synthetic progestin medroxyprogesterone acetate is added to the regimen.

Progesterone

ü      is commonly prescribed for perimenopausal women to counteract “estrogen dominance.”

ü      minimizes the risk of endometrial cancer in women who are receiving estrogen.

ü      is preferred by women who had previously taken synthetic progestins, according to a Mayo Clinic study.

ü      may enhance the beneficial effect of estrogen on lipid and cholesterol profiles and exercise-induced myocardial ischemia (reduced oxygen supply to the heart muscle) in postmenopausal women (in contrast to medroxyprogesterone acetate).

ü      therapy may minimize the side effects associated with synthetic progestins.

Androgens

Testosterone and dehydroepiandrosterone (DHEA) may be added to a woman’s HRT to alleviate recalcitrant menopausal symptoms and further protect against osteoporosis, loss of immune function, obesity, and diabetes. A decline in serum testosterone is associated with hysterectomy, and there are age-related gender-independent declines in DHEA and DHEA-sulfate. Additionally, ERT may cause relative ovarian and adrenal androgen deficiency, creating a rationale for concurrent physiologic androgen replacement.

Andropause and Testosterone Replacement for men

Men frequently experience declines in testosterone levels that correlate with the hormonal changes that women experience at menopause; however, men typically have a slower and more subtle hormonal decline, and develop symptoms over a period of time. When hormones are replaced or restored back to physiologic levels considered normal for younger males, men may experience a dramatic reversal of many of these changes.

Goals of Testosterone Replacement Therapy in Men (>50 years)

ü      improvement in psychological well-being and mood

ü      improvement in erectile dysfunction and libido

ü      increased muscle mass, strength, and stature

ü      preservation of bone mass

ü      and possibly a decrease in cardiovascular risk

Natural testosterone must not be confused with synthetic derivatives or “anabolic steroids,” which when used by athletes and body builders have caused disastrous effects, even resulting in heart problems and cancer.

Andropause therapy may also include dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), chrysin, zinc, selenium, and other supplements.

Thyroid Hormone Therapy for women and men

Symptoms of hypothyroidism (low levels of thyroid hormone) include fatigue, cold and heat intolerance, hypotension, fluid retention, dry skin and/or hair, constipation, headaches, low sexual desire, infertility, irregular menstrual periods, aching muscles and joints, depression, anxiety, slowed metabolism and decreased heart rate, memory impairment, enlarged tongue, deep voice, swollen neck, PMS, weight gain, hypoglycemia, and high cholesterol and triglycerides. Yet, more than half of all people with thyroid disease are unaware of their condition.

Although both T4 (thyroxine, an inactive form that is converted to T3 in other areas of the body) and T3 (triiodothyronine, the active form) are secreted by the normal thyroid gland, many hypothyroid patients are treated only with levothyroxine (synthetic T4). Some hypothyroid patients remain symptomatic, and T3 may also be required for optimal thyroid replacement therapy. However, the only commercially available form of T3 is synthetic liothyronine sodium in an immediate release formulation which is rapidly absorbed, and may result in higher than normal 13 concentrations throughout the body causing serious side effects, including heart palpitations. Research indicates there is a need for sustained-release T3 preparations to avoid adverse effects.

A randomized, double-blind, crossover study found inclusion of T3 in thyroid hormone replacement improved cognitive performance, mood, physical status, and neuropsychological function in hypothyroid patients. I of patients preferred T4 plus T3, and tended to be less depressed than after treatment with T4 alone.’ Patients and their physicians may wish to consider the use of sustained-release 13 in the treatment of hypothyroidism, particularly when the response to levothyroxine (14) has not been complete.

Adrenal Fatigue

The adrenal glands secrete hormones such as cortisol, estrogen, and testosterone that are essential to health and vitality and significantly affect total body function. After mid-life, the adrenal glands gradually become the major endogenous source of sex hormones in both men and women. Intense or prolonged physical or emotional stress commonly associated with modern lifestyles or chronic illness can lead to Adrenal Fatigue, which is an important contributing factor in health conditions ranging from allergies to obesity.

Anti-inflammatory and anti-oxidant adrenal hormones like cortisol help to minimize allergic and negative reactions, such as cancer and autoimmune disorders. These hormones closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy, and cardiovascular and gastrointestinal function. Proper adrenal support is essential to complete the hormonal pathway to optimal health, and includes proper nutrition, getting plenty of sleep, regular moderate exercise, stress management, slowing down to regain a proper perspective on life, and replacement of deficient hormones.