Youthful Hormone Optimization

“We have it in our power to begin the world over again” – Thomas Paine

“We age because our hormones decline. Our hormones do not decline because we age.” This is the mantra for the Neuroendocrine theory of aging. Hormones are chemical substances in our bodies that are released to have an effect on tissues somewhere else in the body. They act as biochemical messengers. They turn on cell functions and tum off cell functions. Gene expression can be altered by the presence or absence of hormones. Hormones control our responses to illness by controlling our immune system, our responses to stress, our sexual development, our growth and our metabolism. When hormone levels are balanced and at optimal levels, we are more likely to enjoy good health provided our lifestyle choices are also healthful.

Whereas nerves are a hardwired means of communication throughout the body, it helps to visualize hormones as the biological equivalent of a wireless communication system, only more complex. A central ‘server’ – the hypothalamus – is the key to maintaining the balance of hormonal communication flow. Most hormones convey their information by traveling through the bloodstream. The biological messages carried by hormones are specific and not intended for every cell in the body. At the same time, some hormones act on multiple cell types. Three types of hormonal systems (endocrine, autocrine, and paracrine) constitute the biological communication system. All three systems working together can effectively prevent accelerated aging. Any miscommunication is like a weak link in a chain that leads to hormonal chaos and possibly accelerated aging.

Optimal hormonal levels occur when a person is in his/her twenties and thirties, and may continue for another 15-20 years with a subtle decline. Generally, during this same span of time fewer diseases arise than during almost any other time of life. Cancers are less likely, occurring more frequently in younger and older ages, as a rule. Diabetes is more common among younger and older individuals. Heart disease, bone fractures, infections, and so on, seems to predominate before and after these years. This lends to the feelings of invincibility experienced during our twenties and thirties. Beginning in our late thirties, however, hormone levels begin a steady decline. We do not usually notice the effects until about our early forties or occasionally, late forties and early fifties. As the hormonal communication system declines, the body begins to age more rapidly. Biological age is intimately tied to the health of the endocrine system. Any decline in the hormone system has negative consequences on longevity by increasing the likelihood of death.

Unlike the predictable decline experienced with most hormones, a few hormones tend to increase with age – insulin and cortisol for example. Corticosteroids are hormones manufactured in the adrenal glands and are critical to the body’s response and management of stress. Large amounts of cortisol are released in response to stress. While this is an essential function for survival, when stress is prolonged it can damage the feedback loop that regulates cortisol levels. Prolonged and uncontrolled cortisol secretion exhausts the body. It can inhibit the immune system, slow protein synthesis, and lead to neuronal loss, brain damage, bone loss, muscle wasting, increased abdominal fat, psychosis, premature aging, and death. One definition of aging says aging is the deterioration of the body’s ability to respond to stress.

Cortisol, insulin, melatonin, pregnenolone, DHEA, progesterone, estrogen, testosterone, and growth hormone are among the hundreds of known hormones that must play like the keys of a grand piano in response to environmental sheet music. However, prolonged cortisol secretion drives down the levels of many of these and other hormones. With fewer hormones in place to regulate and mandate order, everincreasing cellular and system disorders arise.

Hormone declines determine many of the biological markers that change as you age. Hormone changes, then, may be thought of as secondary markers of aging. Therefore, a significant step toward controlling aging lies in the ability to replenish and balance hormones. The right balance of hormones can help manage and maybe even slow the rate of the aging process; the wrong balance will certainly accelerate it. One of the goals of preventive-aging medicine is to replenish hormone levels equivalent to those found in a healthy 25-30 year old individual. The reason becomes more apparent by answering the following questions: When do most cancers occur? When do most bone fractures occur? When do most serious infections occur? When do most medical problems occur? The answer is that they occur more often in the very young and in the old. Overall, most people are at their peak of health from the mid-twenties to the late thirties. However, it’s not always just the lack of certain hormones that is the fundamental cause of aging, but how hormones lose their ability to communicate with each other to maintain balance. Fortunately, biologically identical hormone replenishment therapy, when clinically indicated, can potentially help improve a person’s physical and mental functional status to that of a person 10-20 years younger; provided one also makes healthful nutrition choices, exercises appropriately, effectively manages responses to stress, balanced with emotional and spiritual health.

The Priorities of Hormone Balance 

Simply taking prescription hormones does not automatically result in optimal results. The truly great benefits from hormones can be realized only by addressing them in the following three orders of priority. The first order of priority for optimizing your hormones is to balance the hormones that contribute to inflammation, pain, excessive blood clotting, cancer, and so on. These hormones are called eicosanoids, of which there are likely hundreds. You may be familiar with a class known as prostaglandins, or the leukotrienes, for example. How should the first order of priority be addressed? With healthy choices involving all aspects of lifestyle – nutrition, exercise, stress management and maintaining a healthy body composition. Unless the first priority of hormone balance is addressed first and sufficiently, the next two orders of priority will most likely prove to be far less effective. This point cannot be emphasized too strongly.

The second order of priority for hormone balance is to enhance the body’s own natural production and secretion of hormones, and improve cellular hormone receptor sensitivity. The goal here is to optimize the effectiveness of remaining hormones. It is possible to significantly boost declining levels of critical hormones, such as testosterone and growth hormone, while reducing harmful increases in hormones like cortisol and insulin. Metabolic pathways and enzyme actions affecting hormone levels can be inhibited, resulting in hormone level changes. This step, like the first priority, combines a balanced nutritional lifestyle with a program of regular exercise, stress management, with targeted nutritional supplementation. For example, the enzyme aromatase converts testosterone to estradiol, a process known as aromatization. This can be troublesome for men as too much estrogen may be a contributing factor in the development of prostate disorders and very high levels may increase the risk for heart disease in men. Unfortunately, testosterone aromatizes to estradiol more readily with age, excess body fat, zinc deficiency, too much alcohol consumption, and so on. In this example, the second order of priority begins with efforts to minimize aromatization of testosterone to estradiol: a hormonally balanced nutritional lifestyle and exercise to lose excess body fat, increased dietary zinc, and reduction of alcohol consumption. Additionally, supplemental zinc, large doses of vitamin C, and a plant-based nutritional supplement know as chrysin may further interfere with aromatization of testosterone to estradiol. Furthermore, the second order of priority strives to improve the body’s natural production of testosterone with a program of weight training. In some instances, first and second levels of intervention alone result in adequate hormonal balance, without the need to move to the third order of priority – hormone replacement therapy.

When the first two orders of priority fail to fully optimize hormones, the third and final order of priority calls for prescribing hormone replacement. The goal of prescription hormone replacement therapy is to achieve hormone balance at youthful but safe levels for as long as possible. In many instances, all three priorities may be implemented simultaneously.

Biologically Identical Hormone Replenishment Therapy 

Biologically identical hormones, often referred to as bio-identical, or ‘natural’ hormones, are identical in molecular structure to the hormones the body makes. When a bioidentical hormone circulates through your system and binds with a receptor, the fit is the same as if your body had produced that hormone. Synthetic hormones may be foreign to the body and are often treated by the body as toxins. They may not have the same molecular structure as human hormones. When one of these binds with its receptor, the fit is not exact, sometimes resulting in side effects.

Biologically identical hormones generally provide advantages over synthetic hormones when metabolized. Metabolism is performed by enzymes whose work is to break down (metabolize) hormones – the enzymes won’t metabolize hormones they don’t recognize, which can cause non-bio-identical hormones to sit on the hormone receptors longer than they should, which in turn can cause over-stimulation of the receptors and possible side effects. Additionally, to be effective hormones need to communicate with other hormones. Synthetics don’t always do this effectively or correctly. The goal is to improve cellular communication, restore balance and optimize function. The optimal approach replenishes all suboptimal and deficient hormones at one time.