Hormones are chemical substances that our body produces in different glands and which are responsible for regulating most of our body functions.
At Neolife we’re not doing an extravagant treatment, it’s only a more advanced understanding of hormone management, which comes from our training in institutes that have spent years in this area and from our experience in these years in which we’ve treated hundreds of patients.
Dr. Iván Moreno – Neolife Medical Team
The correct functioning of hormonal axes is vital for keeping our tissues, organs and functions in optimal condition.
Replacement therapy or bioidentical hormonal optimization is one of the essential foundations of treatment at Neolife (when it is necessary and always adapted to the particular circumstances of each case).
Though it is striking and contradicts many of the prejudices we have with respect to hormones, it’s true that in the centers in the United States where we trained they have been working on this for about 25 years. Experience accumulates and the benefits of it are expanding into the scientific arena.
This week two items of news in Medscape, one of the most important medical dissemination platforms in the world, show that, far from being a radically new therapy, it is being established as a new standard which in a few years will be the usual way to prescribe hormone therapy.
- US Docs More Likely to Prescribe T3/T4 Combo Tx for Hypothyroid.
- Bioidentical Hormone Combo Improves Sleep After Menopause.
We are briefly going to review the importance of this treatment and the particular details of our approach, which as we see is that of more and more professionals.
Hormones are very important.
The correct functioning of hormonal axes is vital for keeping our tissues, organs and functions in optimal condition.
Hormones are chemical substances that our body produces in different glands and which are responsible for regulating most of our body functions.
In the case of sexual hormones, a progressive loss begins in men after the age of 40, and there is a much sharper loss in the case of women, who in the years prior to the menopause already have low levels of progesterone and testosterone and after the menopause of estradiol too.
In the case of other hormones such as melatonin, DHEA or thyroid hormone the loss of secretion is gradual due to atrophy of the gland, deregulation of the production and lesser sensitivity of the cell receptors where the hormones must bind.
Once we have reached a certain age and, in the case of sexual hormones, once we cease to be fertile, the result of the loss of hormone levels is the deterioration of all the organs in which these hormones have receptors (most of them).
The loss of the correct hormone balance alters cellular intercommunication and is one of the mechanisms of aging. Fortunately, it is one on which we can act.
Hormone replacement/optimization is safe.
The use of hormones has been subjected to a smear campaign in recent years. The fact is that this smear campaign, like many others, has some basis in truth, but not because hormones are harmful (our body wouldn’t produce a substance that is toxic or harmful to itself), but because we’ve been using without respecting two important rules:
1) You have to use the same hormone as our body had.
Our hormones are molecules designed by evolution over the course of thousands of years, which fit and do their job perfectly on cell receptors. But what we’ve been using for years and in some clinical studies in which side effects were seen are synthetic derivatives of hormones. These derivatives are substances designed in a laboratory so be sufficiently similar to the original hormone as to work, but sufficiently different to be able to be patented.
We can’t try to make them the same, but nevertheless we’ve been using hormone derivatives on the premise that “they are the same…but better”:
- “They’re the same but they can be used as a patch”
- “They’re the same but they can be impregnated in an IUD”
- “They’re the same but stronger”
Clinical studies are very costly, and the first studies that were carried out used synthetic hormones, since they have a limited patent term with results that are rushed through.
In those studies equine estrogen and progesterone derivatives were used (medroxyprogesterone) and, indeed, side effects appeared.
Bioidentical hormones (the same molecule as that which exists naturally in our body) cannot be patented, and research is much slower, in universities, with public financing, health institutes, etc. However, after almost 30 years the evidence is beginning to accumulate… And it’s as we expected: using bioidentical hormones is not the same as their derivatives.
It’s normal for us to have had side effects with those hormones, effects that in study after study do not appear with bioidentical hormones.
2) You have to reach levels that our body (in particular) had.
We are very used to taking an antibiotic or an anti-inflammatory at the same dosage for almost the entire population, making an exception only for people of very low or high weight or children.
On that same premise we’ve all thought it was normal for the dosage of a contraceptive to be standard or the dosage of a hormone therapy for the menopause to be the same for different women. When side effects appear the alternative we usually offer is to change to another pharmaceutical or cease taking it, but the dosage is not usually adjusted.
I usually use an example to help to understand the complexity and the need to adjust the dosages: insulin is a hormone and the need for different dosages for different people and the need to adjust it escapes nobody.
Using a touch of humor, I usually say to patients that the first 90% that ensures the safety and effectiveness of hormone optimization therapy is to use appropriate (bioidentical) hormones. The second 90% is to personalize the dosages. They don’t add up to 100% but nobody said medicine was simple.
At Neolife we’re not doing an extravagant treatment, it’s only a more advanced understanding of hormone management, which comes from our training in institutes that have spent years in this area and from our experience in these years in which we’ve treated hundreds of patients.
As the scientific evidence accumulates, this way of doing things will be extended until it becomes a common practice.
The specific examples
At the outset we discussed two news stories that put these ideas we’ve discussed into perspective.
The first of them “US Docs More Likely to Prescribe T3/T4 Combo Tx for Hypothyroid.” illustrates the concept of how to manage the thyroid axis has changed to conform more closely to recent evidence. It shows the need to replace the two hormones that our body has T4 (levothyroxine, circulating form) and T3 (tri-iodothyroxine, most active form) and not only T4, which is what is traditionally done.
There are numerous studies that show that replacing only one of the two hormones causes a partial correction of the problem, not helping with the correct functioning of metabolism, weight and cholesterol correction and recovery of the typical lack of energy that appears in hypothyroidism.
And not only do studies support it, we have many cases in which, by simply changing levothyroxine for a combination of the two, the life of the patients has completely changed.
Traditionally, it has been explained to us that upon replacing T4 it would be automatically converted into T3, but the fact is that there are many factors that determine this: stress, being on a slimming diet, pollution, some people have a lower conversion rate… there are many reasons why replacement with only T4 does not work.
In the USA, this approach, which until recently was controversial is being used more widely and before long nobody will consider replacing thyroid metabolism with half the hormones that our body had.
The second news story “Bioidentical Hormone Combo Improves Sleep After Menopause” shows how the concept of bioidentical hormone, insofar as it has different benefits and risks than a synthetic hormone derivative, is no longer a manner of speaking for alternative doctors but rather the medical community is accepting the scientific evidence and changing the paradigm of “all hormones are equal”.
In this case they show that the use of estradiol and progesterone, the same as our body had prior to the menopause, improve one of its symptoms: insomnia or the loss of sleep quality.
In this case the improvement comes from the disappearance of hot flashes, both with estradiol and with progesterone and due to the sedative and relaxing effect of progesterone.
Again the difference is enormous, therapy with estradiol and progesterone has shown that it eliminates most of the mood disorders that appear in the peri/menopause and cause wellbeing, but progesterone derivatives do not have those benefits and there are even recorded cases of depression and suicidal ideation.
Progesterone does not cause breast cancer, in fact there are studies with women who already have that cancer in which progesterone is used as a treatment against breast cancer. However, progesterone derivatives cause an increase in breast cancer, all of them to a greater or lesser extent.
Progesterone derivatives are responsible for our associating hormones with more coagulates, but progesterone is not associated with more coagulates.
And that goes for so many other side effects. Bioidentical hormone optimization is not risk-free, and it must be done properly, but it does not increase the presence of cancer, thrombosis and heart attacks.
We understand that this advanced approach clashes with beliefs and prejudices of patients and of other professionals, and we teach in order explain why we do what we do. We firmly believe that this gives our patients security and allays the concerns of the other doctors who treat them for other pathologies.
What we do is based on an experienced interpretation of the scientific evidence, but it is firmly established in it.
At Neolife we carry out hormone optimization after a careful assessment of the imbalances present, choosing bioidentical hormones and using analyses and symptoms to adjust the treatments as precisely as possible to the specific needs of each patient.
BIBLIOGRAPHY
(1) https://www.medscape.com/viewarticle/907416 nlid=127097_2043&src=WNL_mdplsnews_190111_mscpedit_obgy&uac=286768PK&spon=16&impID=1857724&faf=1#vp_2
(2) https://www.medscape.com/viewarticle/907360?nlid=127097_2043&src=WNL_mdplsnews_190111_mscpedit_obgy&uac=286768PK&spon=16&impID=1857724&faf=1
(3) Campagnoli C, Clavel-Chapelon F, steroid RKTJO, 2005. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. Elsevier. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974841/
(4) Tariq A, Wert Y, Cheriyath P, Joshi R. Effects of Long-Term Combination LT4 and LT3 Therapy for Improving Hypothyroidism and Overall Quality of Life. Southern Medical Journal. 2018 Jun;111(6):363–9.