Balance Hormones without a Prescription Lynn Lafferty, Pharm.D., N.D.
Cholesterol
Pregnenolone
Hydroxypregnenolone
Dehydroepiandrostero ne DHEA
Progesterone
Hydroxyprogeterone
Androstenedione
Androstenediol
Testosterone 5-a-reductase metabolites
11-Deoxycorticosterone
Deoxycortisol Estrone
Estradiol
Dihydrotestosterone (DHT)
Corticosterone Androstanediol
Cortisol 18Hydroxycorticosterone
16-hydroxylation metabolites
16-aHydroxyestrone
Aldosterone
Na+/
K+ Balance
Anti-Inflammatory Sugar Stabilizer
Estriol
2-hydroxylation metabolites
2-Hydroestrone
2-Methoxyestrone 2-Methoxyestradiol
Liver Detoxification BIOTRANSFORMATION TOXIN Drugs Pesticides Food additives Hormones Histamine
PHASE I
PHASE II
*500-1,000 enzymes * Sulfation CYP450 *Glucuronidation * Acetylation * Oxidation * Glutathione/aa * Reduction conjugation * Hydrolysyis * Methylation
Assessment
Tests Saliva Test Blood Test Stool Test Symptom Survey GI Liver Toxicity Sympathetic dominance Hypo/Hyper adrenal Hypo or hyper thyroid Sugar Deregulation
Regland’s Test Temperature Test Iodine Test
Liver/Gallbladder
Detoxify hormones, drugs, and chemicals
Hormones are altered or excreted
Thyroid Most steroid (estrogen) hormones
Can lead to excess accumulation of hormones
Formation of Bile Storage of vitamins and iron Formation of factors used in blood coagulation
Estrogen Metabolism
Hydroxylation
2 hydroxyestrone (Good/weak) 4-OH and 16 OH (Continued proliferation activity)
Methylation
Cruciferous vegetables
By COMT enzymes
Glucuronidation
Some enzymes in gut can compromise this
Testosterone
Oxidation Reduction
Detox Recommendations
Milk Thistle and/or silyamarin Artichoke Juniper Berry Yellow Dock Oregon grape Dandelion
Beets and beet root Bovine liver Defatted wheat germ Burdock Chaparral Green Cruciferous Veg.
Liver/Gallbladder Toxicity
Dry skin Itching skin and feet Rashes Bitter metallic taste Greasy, milk foods upset, cause pain or watery stool Low thyroid symptoms
Bad Breath Headaches Falling Hair Pain in area Hormone issues
Liver Problems can cause Thyroid Problems
Need selenium for actions May need to detox liver (phase 1 & 2 detox pathways) Liver repair if needed with liver protomorphagen
Yeast Spit Test
First thing in the morning spit in a glass of room temperature filtered water and watch every 15 minutes Yeast Indicated if:
Cloudy String
Stomach and Small Intestine
Gastrin
Stimulates HCl production in stomach
Small Intestine
CCK (Cholecystokinin)
Gallbladder Contraction Release of pancreatic enzymes
Secretin
Stimulates pancreas to release Sodium Bicarbonate to increase pH
Link Between Thyroid and Pathogens
Several studies show a strong link between AITD (both Hashimoto’s and Graves’) and gluten intolerance. Yersinia enterocolitica (Graves) Yeast
Recommendations
No Stomach Acid or digestive enzymes
Betaine Stomach tissue factors Pancreas enzymes and glandular Pepsin
Too Much Acid (Mucus building herbs)
Okra Aloe Vera Marshmallow Slippery elm
Natural Balancers of the Gut
Probiotics Prebiotic Golden Seal Oregano Oil Grapefruit seed extract
Recommendations
Constipation
Fenugreek Bile salts Fennel seed Cascara Sagrada Ginger Aloe Vera
Recommendations
Reflux
Toxins in Bowels
Meadowsweet Chamomile Licorice Aloe Vera Gel or juice Bentonite Clay Chlorophyll capsules
Healers
Apple Pectin Collinsonia Root
“Vascular astringent” Hemorrhoids
Thyroid
T4 (Thyroxin)
T3 (Triiodothyroxine)
Turned into T3 mostly in liver Stimulates metabolism in cells
Calcitonin
Promotes calcium intake into bones Decreases extracellular calcium
Diet
Mostly raw foods to give pancreas a break
Salads
Dressings with herbs and vinegar
Vegetables Juices
Fresh organic fruit
Pectin
Prebiotic Decreases testosterone and estrogens Fermented Foods with good bacteria
Raw cheese, milk yogurt Cultured or fermented vegetables, Kefir Kombucha Raw apple cider vinegar
Lean Proteins
Thyroid Natural Balancers
Bacopa found to increase T4 in animal studies Bladderwreck has iodine Prolamine Iodine Thyroid Protomorphagen
Glandulars
Whole Glands
Only used short term because of atrophy Contains all factors of the glands
Hormones Enzymes Tissue Factors
Thyroid Adrenal Thymus Spleen
Factors Affecting Adrenals
Hypoadrenal
Weak nails Chronic fatigue Crave salt and sugar Brown spots Respiratory Disorders Swollen Ankles
Circulatory Disorders Dizziness when you get up quickly Depression Tired
Whole Food Nutrition vs. Drug Store Vitamins
Regular Vitamins made like drugs
High quantities of a chemical extractions A scientist decided this ingredient was the most active
Whole Food Supplements
Should be organic when possible Contains complexes with things that have not been studied Digested, metabolized, utilized and excreted like food
Glandulars: Cytosol Extracts
Cytosol Extracts
From cell cytoplasm which is inside the membrane of the cell The cytoplasm is the site where most cellular activities occur, such as many metabolic pathways like glycolysis and processes such as cell division. Used in more acute cases
Protomorphogens
Can be used long term Extracts of nucleic acids from cell nucleus
RNA (Ribonucleic)
messenger, transfer, ribosomal DNA and Protein synthesis
DNA (Deoxyribonucleic acid)
Contains genetic instructions in development and functioning of all living things Carries the “genes” Held together by sugars and phosphate
Recommendations
Phosphorylated Serine Organic Minerals Vitamin C complex in whole food supplement Adrenal Protomorphagen Desiccated anterior pituitary Manganese Calmative Herbs with withinia, St John's Wort, Schisandra, Damiana and Skullcap Calcium Vit E2 Complex
Recommendations
Desiccated adrenal 2 times a day for 3045 days Vitamin B whole food complex Vitamin C whole food complex Vitamin B12 Trace Minerals Licorice
Adaptogen Refers to a natural herb product that is proposed to increase the body's resistance to stress, trauma, anxiety and fatigue
Eleuthero Licorice Maca Holy Basil Ginseng Rhodiola
Schisandra Ashwagandha/Withania Cordyceps Noni Chaga mushroom Reishi mushroom
Licorice
Licorice has antispasmodic, anti-inflammatory, laxative, and soothing properties May block metabolism of prostaglandins E and F2 alpha Reduces conversion of Cortisol to inactive cortisone in the kidneys Licorice decreases testosterone production in men who eat licorice
Likely due to glycyrrhetinic acid inhibiting the enzyme 17hydroxysteroid dehydrogenase, which converts androstenedione to testosterone Glycyrrhetinic acid also seems to inhibit 17-20 lyase which converts 17-hydroxyprogesterone to androstenedione
Reference:
Natural Medicine Comprehensive Database
Licorice
Uses:
Adrenal insufficiency (Addison's disease) Aplastic anemia Apthous ulcers / canker sores Atopic dermatitis Bleeding stomach ulcers caused by aspirin Dental hygiene Dyspepsia (functional) Familial Mediterranean Fever (FMF) Herpes simplex virus High potassium levels resulting from abnormally low aldosterone levels
HIV Hyperprolactinemia (neuroleptic-induced) Idiopathic thrombocytopenic purpura Inflammation Polycystic ovarian syndrome Reducing body fat mass Upper respiratory tract infections Viral hepatitis (SNMC) Peptic ulcer disease
Ashwaganda/Withinia
Adaptogen Sedative Anxiolytic Analgesic Antipyretic Immunomodulatory Hypotensive Anti-inflammatory Antioxidant effects Stimulate respiratory function Smooth muscle relaxation Stimulate thyroid synthesis and/or secretion
Thyroid
Thyroxin (T4)and tri-iodothyronine(3)
essential for normal organ growth, development and function. regulate the basal metabolic rate of all cells, including hepatocytes, and thereby modulate hepatic function; the liver in turn metabolizes the thyroid hormones and regulates their systemic endocrine effects.
Thyroid Conversion
The thyroid gland secretes
110 nmol of thyroxine(T4) 10 nmol of tri-iodothyronine(T3) each day.16 T3 has ten times greater affinity and efficacy than T4 for the nuclear receptor, There are t 3 groups of enzymes that regulate thyroid hormone metabolism, forming part of the iodothyronine selenodeiodinase enzyme system
They are responsible for the activation of T4 to T3
Hypothyroid
Gaining weight inappropriately or unable to lose weight My "normal" body temperature is low Frequently feel cold Fatigued, exhausted more than normal Hair is rough, coarse dry, breaking, brittle, or falling out Skin is rough, coarse, dry, scaly, itchy and thick Nails have been dry, brittle, and break more easily Voice has become hoarse, husky or gravelly Feeling depressed, restless, moody, sad Difficulty concentrating or remembering things Puffiness and swelling around the eyes, eyelids, face, feet, hands and feet
Bacopa (Brahmi)
Memory
Possible mechanisms for cognitive improvement include modulation of acetylcholine release, choline acetylase activity, and muscarinic cholinergic receptor binding
Thyroid effects:(200mg/kg) leaf extracts increased T(4) concentration in male mice, suggesting its thyroid-stimulating role
increased T(4) concentration by 41% without enhancing hepatic lipid peroxidation (LPO),
hepatic LPO was decreased and superoxide dismutase (SOD) and catalase (CAT) activities increased showing its antiperoxidative role
Withania/ Ashwaganda
Shown to increase T4 Antiperoxidative (antioxidant)
Hyperthyroidsm
Graves Disease
Hashimoto’s Thyroiditis
Autoimmune Excessive T4
Autoimmune Thyroid burns out to hypothyroidsm
Link to anaerobic bacteria Link to celiac(5 times more thyroid problems)
Yesina
Oregano oil, berberne(Golden seal), Garlic, Coconut oil, Black hull, cat’s claw, pH balancer to promote growth of important gut bacteria Prebiotic and probiotic
Recommendations
Liver Cleanse Natural Anti-biotics Thyroid Protomorphagen Iodine Trace Minerals Calcium/Magnesium Calmative herbs
Peri menopause and Menopause
Decrease of Progesterone from Corpus Luteum (peri) Menopause “Loss of ovarian function characterized by cessation of menses
↓ Estrogen ↓ Progesterone ↑ LH ↑ FSH
Cholesterol
Pregnenolone
Hydroxypregnenolone
Dehydroepiandrostero ne DHEA
Progesterone
Hydroxyprogeterone
Androstenedione
Androstenediol
Testosterone 5-a-reductase metabolites
11-Deoxycorticosterone
Deoxycortisol Estrone
Estradiol
Dihydrotestosterone (DHT)
Corticosterone Androstanediol
Cortisol 18Hydroxycorticosterone
16-hydroxylation metabolites
16-aHydroxyestrone
Aldosterone
Na+/
K+ Balance
Anti-Inflammatory Sugar Stabilizer
Estriol
2-hydroxylation metabolites
2-Hydroestrone
2-Methoxyestrone 2-Methoxyestradiol
Ovary and Uterus
Ovarian cycle depends on FHS and LH from anterior pituitary
Target specific receptors on ovary which stimulate enzymes to make hormones FSH and LH surge coincides with ovulation around day 11
Problems
Could they breast feed Brain Trauma
Questions
Hot flashes Night sweats PMS Painful Breasts Acne Depression
Sleep Scanty or missed period Hysterectomy Headaches Dizziness Mood swings
Iodine
Needed for thyroid to work
Goiter Myelination of the central nervous system
Need more during pregnancy Decreases fibrotic breasts
Bio-identical Hormones
Hormones made in a compounding pharmacy to look chemically like human hormones
Yam Soy
Problems
Dose Negative feedback mechanism
Problem Conversion
Xenoestrogens from plastics and environment Liver problems 2-OHE1 to 16α-OHE1 ratio
Lower ratio is significantly increase in breast and possibly prostate cancer Urine Testing Cruciferous vegetable product enhances to a more positive ratio DIM induces certain P-450 enzymes in the liver to block the production of the toxic 16-OH estrogens and enhance the production of the beneficial 2-OH forms.
Glandular Advantages
Re energize your own glands Not guessing to doses Metabolized like food Has glandulars for hypothalamus, pituitary, testes, prostate, ovaries and uterus Less expensive Problem of atrophy solved through protomorphagen and adaptogens
GnRH, FHS, LH
GnRH secreted by hypothalamus LH and FSH released by anterior pituitary LH stimulates testosterone to be secreted by Leydig cells in testes FSH stimulates spermatogenesis GH needed for spermatogenesis
Black Cohosh
Use:
Menopausal symptoms (hot flashes, menstrual migraine) Also: Arthritis pain, infertility
MOA:
Estrogen-like effects that are exerted by an unknown mechanism Preliminary research suggests that black cohosh might:
Act as a partial agonist at serotonin receptors including 5HT1A, 5HT-1D, and 5HT-7 receptors Increases osteoblast activity
Wild Yam
Contain diosgenin,
Phytoestrogen (derived from plants) that can be chemically converted into progesterone Contains saponins, diosgenin which we use to make “natural progesterone in lab” However, thinks it has mild estrogenic activity
Grows mammary tissue in mice without ovary
Chaste Tree/Vitex
The flavonoids in chaste tree exert an effect similar to the hormone progesterone
Plant contains no hormonal compounds Possess dopamine properties that inhibit prolactin and increase progesterone Acts on the pituitary gland
normalizes the release of both follicle stimulating hormone (FSH) and luteinizing hormone (LH)
Used for PMS and Cramps
Other Herbals
Sage
Contains natural estrogens Hot flashes and night sweats
St John’s Wort
Many studies show it decreases depression Lowers anxiety
Testosterone
Distribution of hair Voice Baldness Protein and muscle development Thickens and helps bone grow RBC’s Increases metabolic rate 15%
Questions for Male Hormonal Issues
Do you need to urinate frequently, especially at night Strain when urinating Difficulty in starting urination or holding back urine Inability to urinate Weak or interrupted flow of urine Painful or burning urination Blood in the urine Painful ejaculation Pain in the lower back, hips or upper thighs Sex Drive Muscle decrease Fat around middle increase Sleep
69 yo Male Panel
Saw Palmetto
Use:
Benign prostatic hyperplasia (BPH) Androgenetic alopecia Hypotonic neurogenic bladder Prostatitis/chronic pelvic pain syndrome
Demonstrates antiandrogenic, antiproliferative, and antiinflammatory properties
Noncompetitively inhibits 5 alpha-reductase types 1 and 2 and to prevent the conversion of testosterone to dihydrotestosterone (DHT)
May slow prostate cell proliferation by inhibiting fibroblast growth factor and epidermal growth factor and stimulating apoptosis Laboratory evidence suggests that it inhibits lipoxygenase and cyclooxygenase
Laboratory evidence suggests that it inhibits lipoxygenase and cyclooxygenase
Anti-estrogen, antispasmodic, and alpha-adrenergic inhibitory proper
Stinging Nettles
Reported to inhibit sex hormone binding globulin which has an effect on the androgenic receptors of the prostatic cytosol Inhibits the effects of estrogen May influence the binding of 5 alphadihydrotestosterone with its receptors
Tribulus (Puncture vine)
Increases levels of testosterone, luteinizing hormone (LH), dehydroepiandrosterone (DHEA), and dihydrotestosterone Aphrodisiac activity Tribulus might have anti-inflammatory activity as a cyclooxygenase (COX)-2 inhibitor Tribulus might have anti-anginal activity
These effects are attributed to the protodioscin constituent It seems to dilate coronary arteries and improve coronary circulation It also may lower blood pressure by inhibiting angiotensin-converting enzyme (ACE) Extracts from the fruit and leaves seem to have a diuretic effects, which may explain the traditional use of puncture vine for kidney stones and other urinary problems
Vitamin D
Vitamin D2 ergocalciferol Vitamin D3 cholecalciferol
Vitamin D3 is produced in the skin of vertebrates after exposure to ultraviolet B light from the sun
In liver converted to prohormone calcidiol
Converted into calcitriol the biologically active form of vitamin D, either in the kidneys or by monocyte-macrophages in the immune system
When synthesized in the kidneys, calcitriol circulates as a hormone
acts locally as a cytokine defending the body against microbial invaders
regulating the concentration of calcium and phosphate in the bloodstream, promoting the healthy mineralization, growth and remodeling of bone
Modulates neuromuscular function Reduces inflammation Influences the action of many genes that regulate the proliferation differentiation and apoptosis of cells
Pyridoxine (Vitamin B6)
Converted to pyridoxal 5'-phosphate (PLP) is the principal coenzyme form and has the most importance in human metabolism
Co factor in 100 reactions in the body
Neurotransmitters: serotonin, dopamine, norepinephrine and gamma-aminobutyric acid (GABA) Niacin (B3) Carpal Tunnel, tingling, pain ( increased with hypothyroidism) Helps for detoxification of hormones which may prevent Breast CA Prostate CA
Vitamin C
The adrenal gland is among the organs with the highest concentration of vitamin C (as ascorbate) Cofactor required both in catecholamine biosynthesis and in adrenal steroidogenesis ACTH also causes vitamin C loss from adrenals
Vitamin B
Important for nerves Conversion of hormones Conversion of fatty acid pathway
Women’s Balance
B6
Oil to decrease PG 2 and increase hormone
Fish oil
PMS
Black current seed oil
Chaste Tree
Iodine Cruciferous Vegetables
Men’s Balance
Andropause
Protomorphagen containing testes, pituitary, thyroid and adrenal Heart issues too: Wheat Germ Oil
Low Sex Drive and/or low muscle
Add Tribulus Fish Oil Cruciferous Vegetables Saw Palmetto
Men’s Balance
Prostate Health
Iodine Calcium Saw Palmetto Prostate Protomorphagen Nettles
REFERENCES • • • • • • • • •
•
Sategna-Guidetti et.al. Autoimmune thyroid diseases and coeliac disease. Eur J Gastroenterol Hepatol. 1999 Aug;11(8):939- 40. Kar, A. Panda, S. Bharti. S. Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice. http://www.naturaldatabase.com, Bladderwreck, last updated 3/17/2011 http://www.naturaldatabase.com, Licorice, last updated 3/17/2011 http://www.naturaldatabase.com, Tribulus last updated 3/17/2011 Winston, David & Maimes, Steven. “Adaptogens: Herbs for Strength, Stamina, and Stress Relief,” Healing Arts Press, 2007. Robyn Klein."Allostasis Theory and Adaptogenic Plant Remedies" 2004 Hobbs, Christopher "Medicinal mushrooms: The history, chemistry, pharmacology and folk uses for modern times" Botanica Press, 1987.
http://www.naturaldatabase.com, Black Cohash, last updated 3/17/2011 http://www.naturaldatabase.com, Saw Palmetto, last updated 3/17/2011
REFERENCES
Mayo, J. 1997. A natural approach to menopause. Applied Nutritional Science Report. 5(7):1-8 Women’s Health Initiative Study accessed July 7, 2010.
http://www.nhlbi.nih.gov/whi/
Chrubasik, JE,et. al. May, 2007. A comprehensive review on the sting nettle effect and efficacy profiles. International Journal of Phytotherapy and phytopharmacology. 14(7-8):568-579 Dong Quai (Monograph) reprinted Alternative Medicine Review. (9):4 2004 Adimoelja, A. 2000. Phytochemicals and breakthrough of traditional herbs in the management of sexual dysfunction. International Journal of Andrology, 23 supp. 2:82-84
REFERENCES
Ya-Juan, X., et. al. 2009. Journal of Asian Products Research. 11(6): 548-553 Goldzieher, JW. 1997. Postmenopausal androgen therapy. Fem Patient 22:57. Obermeyer, WR. 1995. Chemical studies of phytoestrogens and related compounds in dietary supplements: flax and chaparral. Proceedings of the Society for Experiemental Biology and Medicine 208:6-12. Andrade C et al. 2000. A double-blind, placebo-controlled evaluation of the anxiolytic efficacy of an ethanolic extract of Withania Somnifera. Indian J Psych. 42(3):295-301. Bone K. 2003. A Clinical Guide to Blending Liquid Herbs. UK: Churchill Livingstone. Braun L, Cohen M. 2003. Herbs & Natural Supplements: an evidence-based guide. 2nd edn. Sydney: Elsevier Australia. Choi K. 2008. Botanical characteristics, pharmacological effects and medicinal components of Korean Panax ginseng. C A Meyer. Acta Pharmacol Sin. 29(9):1109-18. Davydov M, Krikorian AD. 2000. Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an adaptogen: a closer look. J Ethnopharmaco.l 72;345-93. Deyama T, Nichibe S, Nakazawa Y. 2001. Constituents and pharmacological effects of Eucommia and Siberian ginseng. Acta Pharmacol Sin. 22(12):1057-70. Kaneko H, Nakanishi K. 2004. Proof of the mysterious efficacy of Ginseng: basic and clinical trials: clinical effects of medical ginseng, Korean red ginseng: specifically its antistress action for prevention of disease. J Pharmacol Sci .95(2);158-62.
REFERENCES
Kelly GS. 2001. Rhodiola rosea: a possible plant adaptogen. Altern Med Rev. 6;293-302. Kour K et al. 2009. Restoration of stress-induced altered T cell function and corresponding cytokines patterns by Withanolide A. Int Immunopharmacol. 9(10)1137-44. Olsson EM, von Scheele B, Panossian AG. 2009. A randomized, double-blind, placebo-controlled, parallel-group study of the standardized extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 75(2):105-12. Panossian A, Wikman G. 2009. Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity. Curr Clin Pharmacol. 4(3);198-219. Panossian A et al. 2007. The adaptogens Rhodiola and Rai D et al. 2003. Adaptogenic effect of Bacopa monniera(Brahmi). Pharmacol Biochem Behav. 75(4);823-30. Rai D et al. 2003. Anti-stress effects of Ginkgo biloba and Panax ginseng: a Comparative Study. J Pharmacol Sci. 93;458-64. Roodenrys S et al. 2002. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacol. 27(2);279-81. Russo A & Borrelli F. 2005. Bacopa monniera, a reputed nootropic plant: an overview. Phytomed. 12(4);305-317. Tachikawa E, Kudo K. 2004. Proof of the mysterious efficacy of ginseng: basic and clinical trials: suppression of adrenal medullary function in vitro by ginseng. J Pharmacol Sci. 95(2);140-44.