An Intro To Bioidentical Hormones

The human experience is that we peak around 25 years old, then we stay relatively steady for about a decade only to slowly and steadily decline over the next 40 or 50 years.

This is the narrative that we've all come to accept as normal because it's common.

But do we have to? 

In today's episode I'm going to be giving you the two most important reasons why you need to replace your hormones, the two biggest misconceptions about hormone replacement, and a few conversations that you need to have with your doctor about hormone replacement. 

Hormones are chemical messengers that our body produces in the endocrine glands and endocrine organs.  They facilitate communication between cells and organs with virtually every bodily process. 

They also facilitate growth, sexual development, mood, sleep, how we manage stress, and how we digest food. 

Understanding how to optimize your hormones ensures that you're living the best, healthiest, and most vibrant version of you that is possible. 

There are some big misconceptions and fears around hormones and hormone replacement therapy. 

1) Bioidentical hormones are not the same thing as synthetic hormones.  

In normal human biochemistry, hormones are structured and created by nature. Bioidentical hormones mimic our natural biochemistry and have the exact same cellular structure and makeup as the hormones created by the gland or organ that produces it. 

In contrast, synthetic hormones are pharmaceutically manufactured and are not the same at the cellular level. 

2) In terms of hormone levels, normal is not the same as optimal. 

Normal is another way of saying common or average.

Normal ranges are very vast and have profound implications depending on what end of the normal spectrum you are on.

Optimal is when you function as a human being as the best version of you possible.

I use the illustration of driving your car. A normal speed may be 50 mph, but if your goal is to drive across the country you're never going to get there. 75 mph is a much more optimal speed. Right?

See, it depends on what your goals are, it depends on where you're going and how you feel along the way.

Here are the two most important reasons you need to consider replacing and optimizing your hormones. 

1) Optimized hormones reduce disease and increase lifespan.

The data, which I will share with you in future posts, is clear that optimized hormone levels result in improved mortality and morbidity. 

2) Hormones make you feel better.

An example of this is depression, which is a deficiency in the "feel good" hormones serotonin and dopamine. Prozac, a depression medication, increases the levels of these hormones and you start feeling better.

And the way you feel determines the quality of your life.  

Here are the conversations that you need to be having with your doctor today. 

1) What are my hormone level numbers? 

This is going to be very important as we do a deep dive into each of these hormones.

I believe it is very important for you to understand what your levels are. You've got to know your numbers and where they fall on the spectrum. 

2) Are my levels normal or optimal?

If you don't feel good, and your numbers are normal, I would implore you to pursue a conversation around moving those normal numbers to the upper limits of normal first to see if there's a shift in the way you feel. 

3) Do I have any risk factors that need to be considered that outweigh the benefits of hormone replacement therapy?  

  • The first risk factor is pregnancy.

Some hormone replacement is off limits for anyone who is pregnat or thinking about pregnancy. For example, Testosterone is a no-no.

However, there a number of hormones that actually need to be optimized during pregnancy so that you can have a healthy pregnancy such as a hormone called progesterone and thyroid. Deficiencies in both progesterone and thyroid are some of the most common reasons for a second or third trimester miscarriage. 

  • The second risk factor is any clotting disorder.

If you have a known clotting disorder, or a family history stroke or of blood clots in the legs or lungs, some hormones could be risky. 

  • The last risk factor are hormone sensitive cancers. 

Specifically, prostate cancer in men and breast cancer (or a family history of breast cancer) in women. You need to be very, very careful in these instances. 

When discussing risk factors, you don't need to be afraid -- you just need to be careful, and you need to have conversations with physicians who understand these diseases, the benefits of bioidentical hormones, and what risks they may impose should you have one of these risk factors. 

Here are three key take home points regarding hormone replacement therapy:

  • Bioidentical hormone replacement is a big deal.

The reason you felt so good at 25, is due to hormones. There's a reason a 25-year-old feels like they can conquer the world and a 55-year-old feels like they're holding on for their life and it's just slowly and steadily slipping away.

The only difference between a 25-year-old and a 55-year-old other than life experience is hormone levels. 

  • Bioidentical hormones are not the same as synthetic hormones.

We cannot extrapolate that they are the same. We cannot place the same risk or benefit profile on them both because they are different. This is massively important. 

  • When it comes to hormone levels, normal is not necessarily optimal.

Just because you have normal levels doesn't mean you've been optimized on your hormone levels and you really need to get some clarity around this to give you the best chance to prevent disease and the best chance to feel great. 

I hope this introduction to hormones was valuable to you.

In the next post, I will discuss testosterone replacement for men. 

Please leave me your me your comments, questions, and let me know if there are other topics you would like me to discuss in future posts.  

If you prefer video content, please be sure to subscribe to our YouTube channel.  You can also listen to our podcast The Concierge Medicine Show on iTunes

Take care --

Aaron Wenzel, MD

Sarah Wenzel