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hormone seminar hormone seminar Presentation Transcript

  •   “ The compounding specialists” Welcome
  • Hormones
      • Powerful chemical messengers
      • Derived from cholesterol
      • Made in the brain, ovaries, testicles, adrenal glands and body fat
      • Affect every tissue in the body
      • Overall effect depends on the balance between various hormones
      • Duration of exposure is as important as dose
  • Bio-Identical Hormones
      • Bio-Identical Hormones are chemically identical to those in the human body
        • Derived from cholesterol-like molecules called saponins (extracted from soybeans and yams)
          • Plants do not make hormones (only precursors)
        • Some available without prescription (ProGest)
        • Others require prescription
          • a few manufactured products (eg: Vivelle, Estrace, Prometrium)
          • custom compounded medications
    View slide
  • Estrogens Estriol, Estradiol, Estrone
      • Exert a stimulating effect on breast, uterus and brain
      • Prevent bone loss by osteoclasts
      • Involved in vasodilation and improved blood flow
      • Promote fat storage at hips
      • Maintain integrity of urogenital tract
    View slide
  • Progesterone
      • There is only ONE progesterone
      • Works synergistically with estrogens
        • Balances effect of estrogens in many cases
          • slows cell growth
          • normalizes blood clotting
          • enhances estrogen’s cardiovascular benefits
          • decreases fluid retention (bloating)
          • improved fat metabolism
      • Progesterone levels drop at peri-menopause
  • Testosterone
      • Anabolic hormone
        • builds and strengthens tissue, bone, urogenital tract, muscle
      • Declines with age
      • Vasodilator
      • Balances effects of estrogen and cortisol
      • Important for sex drive/sexual response
  • Dehydroepiandrosterone (DHEA)
      • Made in the adrenal glands
      • Declines steadily with age
      • Has important roles in immune function, ability to handle stress, and glucose disposal
      • Balances cortisol
      • Can convert into testosterone and estradiol
  • Cortisol
      • Made in the adrenal glands
      • Catabolic hormone: breaks down tissue (part of the normal cycle of remodeling)
      • Balances testosterone
      • Stress hormone: modulates immune function, raises blood glucose, stores fat for energy
      • In excess: osteoporosis, muscle wasting, obesity, brain neuron atrophy
  • Thyroid Hormone
      • Determines metabolic rate
        • Nutrient utilization by tissue
          • (fats, carbs, and protein)
        • Effect protein synthesis
        • Regulate bone growth
        • Heat generation
      • Interacts with cortisol, progesterone, testosterone and estradiol
  • Female Hormone Patterns Menarche to Menopause
      • Teens
        • Anovulatory cycles are common
        • Low Progesterone
        • Estrogen Dominance
  • Female Hormone Patterns Menarche to Menopause
      • 20 to 30 years old
        • May have regular monthly bleeding but may not be ovulating
        • If stressed: PMS
        • Unbalanced hormone levels affect fertility and pregnancy
  • Female Hormone Patterns Menarche to Menopause
      • 40 to 50 years old
        • Peak progesterone level declines
        • Total progesterone output throughout the luteal phase declines
        • Average estradiol level increases
          • May lead to estrogen dominance
        • Ovaries may secrete more testosterone instead of progesterone
        • Anovulatory cycles with irregular bleeding
  • Female Hormone Patterns Menarche to Menopause
      • 40 to 50 years old
        • Estrogen dominance
        • Functional hypothyroidism
        • Normal TSH, but classic symptoms of under-active thyroid
        • Weight gain
        • Feeling cold
        • Dry skin, thinning scalp hair
        • Aching muscles
        • Fatigue
        • Low sex drive
  • Female Hormone Patterns Menarche to Menopause
      • 50+ & Menopause
        • Estradiol level drops
        • Estrone level stays the same or rises
        • Ovary stops making progesterone and testosterone
  • Symptoms of Hormone Imbalance
      • Estrogen Excess
        • Tender, swelling, and/or fibrocystic breasts
        • Water retention
        • Irritability
        • Weight gain at hips
        • Sometimes increased headaches or migraines
        • Hypothyroid symptoms
  • Symptoms of Hormone Imbalance
      • Estrogen Deficiency
        • Hot flashes & night sweats
        • Vaginal dryness (also lips, skin, eyes...)
        • “ Brain fog” & memory problems
        • Urinary incontinence (stress incontinence)
        • Depression
        • Bone loss
  • Symptoms of Hormone Imbalance
      • Estrogen Deficiency
        • Low percent of body fat = at risk for low estrogen
          • Estrogen CAN be made in body fat...if you have enough!
          • Women with enough body fat may not need estrogen supplementation for menopause
          • Women with low body fat may need extra estrogen
  • Symptoms of Hormone Imbalance
      • Progesterone Deficiency
        • Irregular periods (teens and pre-menopause)
        • Tender and/or fibrocystic breasts
        • Water retention
        • Irritability
        • Anxiety/depression
        • Weight gain at hips
        • Migraines
        • Hypothyroid symptoms
  • Symptoms of Hormone Imbalance
      • Androgen (Testosterone) Excess
        • Acne, oily skin
        • Facial hair growth
        • Weight gain at waist
        • High triglycerides
        • Seen in insulin resistance, polycystic ovary syndrome, obesity
  • Symptoms of Hormone Imbalance
      • Androgen (testosterone) Deficiency
        • Depression
        • Fatigue
        • Vaginal dryness
        • Low sex drive
        • Bone loss
        • Decreased sense of well being
  • Symptoms of Hormone Imbalance
      • Cortisol (Stress Hormone) Excess
        • Irritability, anxiety, feel “burned out”
        • “ Brain fog” & memory problems
        • Bone loss
        • Insomnia & fatigue
        • Low sex drive
        • Weight gain at waist (“apple” profile)
  • Symptoms of Hormone Imbalance
      • Cortisol Deficiency “Adrenal Fatigue”
        • Usually preceded by prolonged stress/chronic illness
        • Fatigue, feel “flat” or “burned out”
        • Allergies; immune function low
        • Feel cold all the time
        • Can’t get started in the morning
        • Low sex drive
        • Depression
        • Unstable blood sugar
  • Approach to Female Hormone Imbalances
      • The solution isn’t always HRT
        • Stress reduction (good diet, sleep, exercise, relaxation training)
        • Weight loss
        • Address insulin resistance
        • Nutrients
        • Herbs
  • Male Hormone Patterns
      • Young Males
        • High testosterone
        • Low estradiol
        • Low progesterone
  • Male Hormone Patterns
      • 35 + years old
      • Testosterone drops about 1% per year
      • Estradiol and estrone may rise; Prog stays low
      • Gain weight around middle
      • Sleep problems associated with excess weight may lead to increased cortisol
      • Abdominal fat converts testosterone to estradiol under the influence of cortisol
      • Cortisol and estradiol directly oppose the action of testosterone
      • High estradiol is sensed by the brain and may shut down testosterone production
  • Approach to Male Hormone Imbalances
      • Weight loss
      • Weight training
      • Reduce dietary estrogen burden
      • Testosterone supplementation
      • Aromatase inhibitors
  • Solving Hormone Problems
      • History 85%
      • Physical examination 10%
      • Lab tests 5%
      • Respect individual differences
      • Endocrinology will always be somewhat of an art, not an exact science
  • Role of Testing
      • Symptoms help us reach a tentative diagnosis
      • Lab testing confirms or refutes the diagnosis
      • Need to do comprehensive testing
  • Thank You John C. Richards Pharm.D. Barbara Dace Pharm.D. Professional Village Pharmacy 916-483-3455 www.ProfessionalVillageRx.com