Talking About Hormones

TALKING ABOUT Hormones

by, Donald Aulds, MD

Hormones are probably one of the most misunderstood chemicals in the body. The term hormones can stand for multiple chemicals including those from the thyroid gland, adrenal gland, pancreas and of course the ovaries or testes. I will try to approach this from the standpoint of a question and answer approach.

WHAT ARE HORMONES? Hormones are chemicals produced in certain organs of the body and released into the blood stream to act on other areas of the body. Some hormones may have mainly a single action while other such as estrogen may act on multiple areas of the body and produce multiple actions in the body.

HOW DO HORMONES WORK? Hormones act on areas of the cell called receptor sites. The receptor site in the presence of the hormone releases some response in the cell to produce the response that is intended to occur. Some of the receptor sites may be blocked by other chemicals to reduce the response to the hormone. Also, synthetic hormones may incompletely act on the receptor site and not produce the expected response.

WHY DO I BEGIN TO HAVE SYMPTOMS RELATED TO HORMONE CHANGES? This is a complicated question, but in order to try to simplify the answer, you must understand that each hormone in the body has a time in which maximum production of the hormone is achieved and production will begin to decrease beyond this point. As a good example, testosterone production peaks in a woman in her later 20’s and in a man in the early 30’s. After this point of life, testosterone will drop in production and symptoms of decreased testosterone can begin. Some conditions or diseases will accelerate the loss of certain hormones.

WHY DO I FEEL TIRED OR CAN’T SLEEP? These two problems are often two of the most common complaints that I hear from patients. The can be multifactorial and can not be helped often without measuring hormone levels. These studies can include evaluation of sex hormones, thyroid hormones, and stress hormones.

IF HORMONES LEVELS ARE NORMAL, WHY DO I STILL HAVE PROBLEM? Reactions to hormones are also affected by other chemicals of the body particularly vitamin D. Vitamin D is con-

sidered a prohormone meaning the it has to be present for the hormone to produce the response that is expected of the hormone. Without adequate levels of vitamins and minerals in the body, the body just does not respond the way it was intended to work. An example, thyroid hormones must have such chemicals as selenium and boron present to work on certain tissues.

WHERE DO THESE CHEMICALS COME FROM? Mainly from foods that we consume or by supplements taken as directed by your physician. The World Health Organization recommends a low caloric diet such as the Mediterranean diet and exercise to boost response of healthy function of our bodies.

WHEN DO SYMPTOMS OF DECREASED HORMONES TYPICALLY OCCUR? For most women and men, symptoms usually start or become significant in the 40’s to 50’s. Some symptoms may show up earlier in certain individuals, but some may not occur until later in life.

WHAT CAN BE DONE FOR THE SYMPTOMS? I always try to select therapies based on a combination of symptoms reported by the patient and the results of lab tests of the hormones. Specific panels of test of hormones are based on the sex of the person. When lab test results are available approaches of therapy can be planned based on the individual’s needs.

AREN’T HORMONES BAD FOR ME? Multiple studies done mainly in Europe have shown that bioidentical hormones (naturally derived hormones) are safe compared to synthetic hormones. One result of a French study showed that testosterone in a woman helps protect against breast cancer along with other benefits to the body. These must be discussed with a physician.

HOW LONG WILL I HAVE TO BE ON HORMONE THERAPY? As long as you are getting benefits from the therapy. There are no studies on naturally derived hormones that show or suggest a time limit for therapy. I tell patient daily that length of therapy is a personal choice, but whenever hormones are stopped, symptoms may return. It all depends on how well you feel, if the hormones are helping control the symptoms, and whether you desire to do everything you can to maintain your health.

Dr. Donald Aulds is an obstetrician-gynecologist in Huntsville, Alabama and is affiliated with Huntsville Hospital for Women and Children. He received his medical degree from Louisiana State University School of Medicine in New Orleans and has been in practice for more than 25 years.