I spent many hours studying the literature and science regarding the importance of the key hormones circulating in our bodies and how they relate to normal physiology and the maintenance of good health.
Most of our hormonal levels decline with age: Dehydroepiandrosterone (DHEA), melatonin, triiodothyronine (T3), estradiol, progesterone, testosterone, and growth hormone. The highest levels occur when we are in our twenties, and as we age, the normal ranges diminish and are by no means the optimal levels that cultivate good health and well-being.
With aging comes a diminished capacity for cellular protein synthesis and a decline in immune function, an increase in fat mass, a loss of muscle mass and strength, and a decrease in bone mineral density. Physical frailty includes falls, fractures, impairment in activities of daily living and loss of independence. Osteoporosis, sedentary life style and chronic debilitating diseases are all important factors in the process of frailty.
The link between obesity and diseases of aging has been well confirmed in numerous studies. These experiments provide powerful evidence that visceral fat tissue has direct effect on age associated insulin resistance. The increase in visceral fat tissue in older people is associated with decrease in serum levels of estrogen, DHEA, testosterone and growth hormone.
Augmenting the lower levels of these and other hormones that decrease with age may better control visceral fat deposition, thereby leading to decreased insulin resistance and to decreased risk of diabetes and atherosclerosis.
Our orientation in medicine has always been to diagnose and treat a disease process. Many of these disease processes: cardiovascular disease, stroke, cancer, and Alzheimer’s disease have all been blamed on the aging process. Conventional medicine has never treated aging as a “disease process” nor has it tried to alter the outcome of the aging process.
For over 10 years my practice has evolved from diagnosis and management of serious cardiovascular problems to also include a very major commitment to the prevention of cardiovascular disease expression and to try and alter and improve outcomes. All of my patients know this because this “Prevention Perspective” is part of my daily conversation and this was why I made the decision to become Board Certified in Clinical Lipidology 10 years ago.
Though I have learned and developed great skills in working on the heart and cardiovascular system, and on the electrical system of the heart, most of my patients know that I have always tried to be more of a complete physician than just working on just the specific organ system alone. If I have practiced as a cardiovascular disease prevention doctor, then I have concluded that numerous aspects of trying to improve health and well-being are required: nutrition, exertion activity, developing psychological and relationship well-being, challenge in career, and the judicious and careful use of medications. The optimization of your body’s hormones is also an intriguing concept that can reap beneficial dividends.
All the hormones mentioned earlier are responsible for the regulation of the body’s temperature, growth, muscle and bone development and maintenance, sexual desire, well-being, healing, immune function and aging.
The neuro-endocrine system allows for communication with every cell in the body. Hormone deficiencies affect every cell in the body and participate in the degenerative changes of aging.
Optimization of these natural hormones (not synthetic) may demonstrate improvement in so many things:
Growth Hormone (hGH) is produced by the pituitary gland and is processed in the liver and converted into a protein called insulin-like growth factor-one or IGF-1. It contributes to ongoing tissue repair, healing, cell rejuvenation, bone strength, brain function, enzyme production, and the integrity of hair, nails, and skin. All major hGH studies have documented improved body composition and function. There is a consistent improvement in muscle/fat ratio. There is a 10 to 20% decrease in fat and a 10% increase in muscle. There is also an increased breakdown of fat with concomitant decrease in cholesterol and triglycerides. There is an increase in exercise capacity, bone density, muscle mass and strength.
DHEA is a hormone secreted by the adrenal glands. It cultivates a “protein building state”. It reduces cardiovascular risk by increasing the breakdown of fat. It may help reverse the deleterious effects of stress on the immune system, and may help restore sexual vitality, and improve mood.
Melatonin is secreted by the pineal gland. It activates at night, in the dark, and affects patterns of sleep. We know that the cells of the body rejuvenate and repair during the deeper stages of sleep. Melatonin helps increase the deeper stages of sleep and this helps enhance immune function. It also has powerful antioxidant effects.
Thyroid hormone: the thyroid hormone that binds to cell receptors and then enters the cell is not thyroxine (T4) but triiodothyronine (T3). Thyroxine upgrades to triiodothyronine on a 4:1 ratio. It contributes to energy levels and temperature regulation and body warmth. Higher normal levels increase fat breakdown, resulting in weight reduction and lowering of cholesterol. It protects against cardiovascular disease and improves cerebral metabolism. It helps to prevent cognitive impairment.
Testosterone is a hormone secreted by the adrenal glands, testes and ovaries. It contributes to muscle mass, strength and endurance, decreased fat, increased exercise tolerance, enhancement of well-being and psychological status. It protects against cardiovascular disease, hypertension, body fat and arthritis. It leads to improved lean muscle mass, increased bone density, decrease in cholesterol, improved skin tone, improved healing capacity and increased libido and sexual performance. It is also present and extremely important in the female as well as the male.
Estrogen is secreted by the ovaries. Estrogen (and we specifically mean estradiol), protects against heart disease, stroke, osteoporosis, Alzheimers Disease and memory disorders. It protects against vaginal atrophy, urinary incontinence, and prevents symptoms of menopause, including hot flashes and temperature disregulation. Estrogen deficiency results in urogenital atrophy, incontinence, sagging skin in the breasts, increased skin wrinkles of the face, increased fatigue, depression, decreased libido. Most importantly, the estrogen prescribed must be a natural estrogen, (estradiol) not a synthetic estrogen (Premarin). The synthetic estrogens have been shown to be harmful.
Progesterone is secreted by the ovaries and reduces symptoms of menopause. It protects against uterine cancer and breast cancer, osteoporosis, and ovarian cysts. The problem is that most U.S. physicians prescribe synthetic progestins, which cause numerous side effects such as bloating, headaches, fatigue and weight gain. Natural progesterone must be prescribed in place of synthetic progestins (a different molecule) to avoid these side effect issues.
Hormones are not drugs. They are natural substances that have existed in our bodies even before birth. The depletion of them contribute to the deleterious aspects associated with aging, and the maintenance of them to optimal levels may help the countenance of well-being, energy, improved health, improved cognition, better stamina, better libido, and maintenance of body integrity as we age.
It is imperative that these replacement hormones be natural, micronized, and produced at the highest quality pharmacies that maintain certification with all appropriate licensure and certification for pharmaceutical grade products. If this is the case, then you are guaranteed that the molecule of the hormone and the delivery of the hormone is consistent, standardized, and reproducible.
As a cardiologist who has focused on not only the critical care of disease management but also the committed care of disease prevention, and then extrapolating that into improved health and well-being, I felt it was imperative that I present this discussion to those who may wish to inquire into the possibility of improved quality of life.