Scott Rollins, M.D.INTEGRATE YOUR HEALTHGrand Junction Free Press Health & Wellness Columnist

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October 11, 2012
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DR. ROLLINS: The Symphony of Hormones

Hormones control just about everything in the body! They are responsible for growth, metabolism, immune function, healing and aging. They control sexual activity, mood, hunger and thirst. They prepare the body for puberty, mating and parenting.And if that were not enough, they control the fight-or-flight response that allows us to perform superhuman feats. And just as musicians in a symphony, if one hormone is not performing correctly then it can affect the entire show.Hormones are chemical messengers produced by various glands throughout the body. Endocrine glands secrete their hormones into the bloodstream to be carried throughout the body, such as thyroid hormone for example. Exocrine glands secrete their hormones into a duct or the surrounding tissue, thus tending to affect a more localized area.Some hormones activate or stimulate the release of other hormones. Most have their effect by instructing the target cell to perform a specific task. There are three main types of hormones in the body - amines, peptides and steroids.Amines derive from amino acids and include adrenalin and thyroid hormone. Peptide hormones are long chains of amino acids and include insulin and growth hormone. The steroid hormones are all derived from cholesterol and make up most of the adrenal and the sex hormones.Hormone production is controlled by a feedback mechanism. The glands that make hormones will change hormone production based on the state of the body and circulating hormone levels. This provides a means to tightly regulate the amount of hormones in the body.The pituitary gland is the control center between the brain and the endocrine glands. A special part of the brain called the hypothalamus constantly monitors the condition of the body and the various hormone levels and sends chemical messages to the pituitary, encouraging it to either increase or decrease the pituitary hormones that control the endocrine glands. This system could be compared to a home heating system, in which the hypothalamus is the thermostat, the pituitary is the control switch, and the endocrine glands are the furnaces.

Hormone deficiencies affect every cell in the body and result in degenerative changes and aging. A predictable decrease in the production of some hormones begins in middle age and continues until old age. Examples include the sudden decline of ovarian sex hormones at menopause, which involves estrogen, progesterone and testosterone. In men, testosterone declines 1-2% every year from its peak about age 30. Some hormones, such as DHEA from the adrenal gland, or growth hormone, slowly decline in both men and women.Hormone imbalances can occur due to lifestyle or pathological conditions that impact the production of hormones. This can mean hormone levels going up or down. This is true with thyroid hormone, or the stress hormone called cortisol. Hormone imbalances also occur as some hormones normally decline with aging, such as estrogen dominance due to progesterone deficiency.Hormones interact in a wonderful and complex manner, such that changes in one hormone system will have an affect on other hormones. For example, stress and the high cortisol that comes with it, will block thyroid production and activity. Cortisol also blunts the effects of sex hormones. Low thyroid will similarly blunt the action of sex hormones and cause sluggish hormone metabolism and elimination. If one is low in thyroid then the body will try to make up for the loss by making more cortisol.Considering the interaction of many hormone systems is a critical part of working with hormone imbalances and deficiencies. The symphony of hormones also requires that hormones be replaced in a logical sequence. Many times I've had patients consult requesting estrogen replacement after menopause, only to find they were also low on cortisol and thyroid. In the process of "rebuilding" their hormone levels, we have to spend a few months working on cortisol first, before they will tolerate thyroid second, before we can finally safely replace the estrogen.

Hormone replacement is not about simply treating the hot flashes or night sweats seen at menopause. It is a proactive process designed to prevent disease and maintain quality of life.As hormone production declines there are inevitable consequences for the body. The degenerative diseases of aging are in part due to the decline in hormone levels. Expecting the human body to operate smoothly without hormones is much like expecting our automobile to just keep running well without oil - and by the time the red light comes on it is too late! In the same manner, humans should keep their hormones at optimum levels in order to get the best performance from the body.Low hormones are often shown by symptoms such as fatigue, depression, anxiety, insomnia, difficulty concentrating, decreased stamina, or low sex drive. Signs of hormone loss might include weight gain, loss of muscle, increased body fat, thinning/aging skin, and decreased sexual performance.The types of hormones used for replacement should only be bioidentical and replaced in a physiologic manner and dose. "Bioidentical" simply means identical to our biology - the chemical molecular structure is exactly the same as that in nature. Many of the side effects and risks of hormone replacement are minimized or erased completely by using only bioidentical hormones. Nature is very, very specific, and making a drug that is similar enough to stimulate a hormone receptor, yet not bioidentical, is asking for trouble.Some of the current recommendations to avoid hormone replacement are based entirely on studies that use synthetic "look-alike" hormones that are NOT bioidentical. I whole-heartedly agree! Drugs such as the progesterone look-alike called Provera should be taken off the market given the well-known negative risks including breast cancer, heart attack and stroke. Bioidentical hormones, and particularly progesterone, have been studied extensively and research shows that progesterone does not share the same risks as Provera.Bioidentical hormones are available in a few commercial products or custom-made by a compounding pharmacy. The compounding pharmacist is not well recognized by modern health consumers, as we are all more familiar with the commercial pharmacy outlets. But compounding is simply the apothecary from days of old. Modern medicine as well as big-pharma owes their existence to the apothecary. The compounding pharmacy of today is a high tech state-of-the-art producer of all sorts of customized medications, including bioidentical hormones.Like a great conductor making a symphony sound glorious, identifying and correcting hormone imbalances requires patience and diligence, but the reward of a healthy hormone system is one backbone of great health!Scott Rollins, M.D., is board certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado ( Call 970-245-6911 for appointments or more information.

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The Post Independent Updated Oct 11, 2012 05:29PM Published Oct 11, 2012 04:27PM Copyright 2012 The Post Independent. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.