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by Erika Schwartz, M.D.
Warner Books, 2004
Click here for ordering information.
Hormones are powerful agents of change in our body. They cause direct changes in our bodily functions and facilitate our body's reactions to environmental changes. All of us-men, women, adults, and adolescents-experience constant hormone fluctuations. How we look and feel is the direct result of our hormone balance.
When our hormones are in balance, meaning all our hormones are working together well, the results are amazing. Our skin looks radiant and fresh, our minds work smoothly, we remember things, we focus well, our weight and moods are stable, our sex drive soars. We are young and healthy.
When our hormones are out of balance, problems can develop. We have difficulty focusing, we get tired and stay tired, we can't catch up on sleep. We become insomniacs, lose interest in sex, get bloated, and gain weight. We develop aches and pains in our joints; our skin gets wrinkled and dry; we get heart disease, digestive problems, arthritis, osteoporosis. We age.
The aging process is the result of years of wear and tear on our body. It mirrors the state of our hormone balance, our genetics, and the type of life we lead.
Understanding how our hormone balance affects everything we do in our lives is key to maintaining health and preventing aging from robbing us of vitality.
The need to understand and make the connection between hormone balance and lifestyle, diet, exercise, stress, sleep, and every part of our lives prompted me to develop the 30-Day Plan.
The goal of the program is to help keep you healthy and youthful for as long as possible. To take you there, we must first gain insight into the connection between health (hormones in balance) and physical and mental deterioration (hormones out of balance). Once this insight is achieved, the 30-Day Plan helps integrate natural hormones, supplements, diet, exercise, and lifestyle into your whole life and effectively accomplish the dream of staying well and delaying the destructive effects of aging on the body and mind.
This book contains all the simple tools and information you need to accomplish the anti-aging goal and to understand the messages that your own body sends you. In addition to the diet, exercise, and lifestyle portions, I will reinforce the balancing program with simple and easily available combinations of natural hormones and supplements.
The natural hormones I endorse and advise you to use are approved by the U.S. Food and Drug Administration (FDA) and have been on the market for twenty years with long track records of safety along with extensive clinical experience in the United States, Canada, and Europe.
The supplements and vitamins I recommend are backed up by reliable and respected scientific research and substantial clinical data that support their safety and efficacy. They are accepted and in use by both conventional medicine and alternative therapies.
But until now, these products have not been combined in the context of a comprehensive program. My 30-Day Plan is the result of more than twenty-five years of experience as a doctor helping solve all types of hormone problems from which my patients have been suffering. Up to now, the information contained in this book was only available to the limited number of people who could be my patients. Now you and your physician can share the 30-Day Plan and help achieve perfect hormonal balance for your body and mind.
The 30-Day Plan will help you integrate your diet, exercise, and lifestyle into a successful hormone-balancing, anti-aging package that uses common sense and proven medical knowledge.
Before we get started, we need to understand what hormones are, and that they are all involved in achieving the balance we need to feel healthy.
Hormones are products of living cells that circulate in our bodily fluids and produce specific effects on the activity of other cells far removed from the organs where the hormones are made. They stimulate or inhibit the actions of cells everywhere in the body. No organ is left untouched by the actions of hormones.
There are hundreds of hormones in our bodies, and they have innumerable jobs. They regulate all bodily functions and interact with each other at all times. No hormone acts on its own. The action of one hormone affects the action of many others and the results vary, depending on infinite internal and external factors.
Hormones are produced through chemical processes by glands and organs in specialized cells. They are made from fatty acids, various combinations of protein components called amino acids, and certain sugar molecules. Most hormones are, in fact, derived from a familiar substance, cholesterol. This is one reason cholesterol should not be dismissed as no more than the culprit behind fatty deposits in our arteries that cause heart disease or stroke. Without cholesterol, our body cannot make hormones-and that's an even graver danger.
Here's a partial list of the better-known and -researched hormones. This list will give you an idea of their names and how their presence is ubiquitous:
Thyroid hormones (triiodothyonine [T 3 ] and thyroxine [T 4 ]).
Parathyroid hormone (parathormone).
Stomach hormones (gastrin, pepsin, trypsin, secretin, and others).
Adrenal hormones (cortisol, aldosterone).
Kidney hormones (renin).
Lung hormones (angiotensin).
Brain hormones (serotonin, melatonin, dopamine, luteinizing hormone, follicle-stimulating hormone, prolactin, adrenaline, endorphins, norepinephrine).
Looking at this list, you probably recognize some familiar names. Some of these, like adrenaline, serotonin, and dopamine, are often called neurotransmitters. They're still hormones, only they're categorized under a specific grouping of hormones that enhance or delay transmission of messages in the nervous system, and in the brain in particular. Another group, estrogen, progesterone, and testosterone, are the sex hormones. Both men and women have all three of them, but they vary in concentration according to your gender.
Some of these hormones are "good" hormones, while others are not. The good hormones help improve well-being and memory, maintain sugar balance, and stimulate positive reactions in your body. The "bad" hormones, when they are out of balance, can be destructive and increase wear and tear on your mind and your internal organs.
Examples of good hormones are: serotonin, progesterone, testosterone, glucagon, aldosterone, dopamine, and growth hormone.
Examples of bad hormones are: cortisol, insulin, and sometimes estrogen.
What's important to remember is that there is no such thing as an independent hormone action. Every action affects everything else going on. Every hormone interacts with others. For us to feel good and stay healthy, every hormone has to work in balance and synchrony. When we look at a list of effects of individual hormones, we are looking at only a small part of the picture.
HORMONES IN BALANCE
If hormones can be said to have a goal in life, it is to maintain what is called homeostasis, which means that they are constantly working to keep us in a state of equilibrium. They strive to maintain balance inside the body regardless of outside environmental conditions. In order to maintain this balance, they react to everything we do. And I mean everything-like eating, sleeping, reading, running, breathing, hugging, having sex, daydreaming, sitting, standing, even thinking.
Remember: Many hormones are working at the same time. This is why no one hormone-or no one anything (vitamin, food, supplement, medication)-will balance us, keep us young, or protect us from our own individual ways of destroying our bodies. And this is why your goal in life should be the same as your hormones'- to achieve homeostasis, through which you can stay healthy and enjoy life.
HORMONES OUT OF WHACK
In an ideal world, we'd all be in homeostasis all the time. But even in the best of times, we don't live in an ideal world. We live busy lives, sad lives, happy lives, working lives, playing lives-all at the same time. Our hormones are constantly adapting to the changes we experience throughout every single day.
Remember: Hormone levels change whenever we change. Regardless of age, as long as we are alive, our hormone levels are changing continuously. When our lives take a new direction, when a stress appears or disappears, our hormone balance changes. If we are lucky enough to have a well-balanced life and are aware of these changes, we can preempt or minimize the problems. But even if we're able to rapidly rebalance, we never totally prevent the most common reaction, hormones out of whack.
Lucy was fifty-eight when I first saw her. She had been a physical education teacher. Diet, exercise, and great personal care were part of her life. Two years earlier, she and her husband won the lottery. They didn't have children or family ties in New York where they lived and decided to retire to Florida. With no worries about work or money, they had only sunny days to look forward to-until the unexpected happened.
Lucy had sailed through menopause at forty-five with almost no symptoms. But now she suddenly started having severe hot flashes, night sweats, insomnia, and mood swings. Suffering with almost incapacitating symptoms, Lucy was convinced she had cancer. She saw three doctors: an internist, an endocrinologist, and a gynecologist. Diagnoses of Lyme disease, arthritis, diabetes, thyroid problems, and cancer were considered but discarded. Finally one of the physicians told Lucy that her problems were probably hormone related, but there was nothing that could be done.
The physician was right about the cause of her symptoms- her problems were an outgrowth of hormone imbalance. But he was wrong when he said there was no solution. When Lucy came to me, I treated her with a combination of natural hormones: estradiol and micronized progesterone in cream form. But treating the symptoms is not always enough. I knew it was essential to find out what had triggered Lucy's sudden hormone imbalance.
I asked Lucy to start a journal. It turned out that for her (as for many other people), retirement was more stressful than her busy life had been. She missed the city life. The stress of the move, and the change of climate and emotional environment, had pushed her delicate hormone balance over the edge. Her hormones were going crazy trying to adjust to so many changes at once.
Within three months, following my program of natural hormones, supplementation, and journaling, Lucy gained a better understanding of her new life and began to feel herself again.
Hormones out of whack can be caused by the smallest of changes in your internal and/or external environments. Never underestimate or overlook any part of your life when doing the detective work of finding what caused your hormones to lose their balance.
Unfortunately, it's all too easy to throw your own hormones out of whack. I know; I've done it myself. I have personally been using natural/bioidentical hormones, the supplement regimen, and the 30-Day Plan for more than five years. Occasionally, however, I behave like every other human being and lose my balance. A perfect example: I had been doing well for months. My hormones were in perfect synchrony. My eating habits were impeccable, and my life was running smoothly without too much stress. A perfect time to throw off my hormone balance-and it all started with a cup of coffee.
I love coffee. Unfortunately, coffee doesn't like me, so I generally avoid it. But one day, I found myself with a yen for coffee. I decided to have just one espresso. I did. No symptoms. I advanced to a double. Still no problem. Within three days, I was drinking two cups of coffee a day. I started getting a little heartburn. I took some Zantac. The heartburn was gone and I continued my coffees. I knew the coffee was causing the heartburn, but I chose to ignore that fact.
Within one week, I started waking up in the middle of the night with night sweats. During the day I experienced an occasional hot flash. Within another few days, I found myself exhausted all the time. Soon after, I started craving sweets, and my commitment to exercise suddenly disappeared. Faced with all these changes, I thought I might be taking too high a dose of natural hormones, so I decreased my dose. My symptoms worsened. Finally, after two weeks of feeling crummy, I decided to face reality. My hormones were out of whack and everything I did added to the problem. I stopped the coffee, went back on my usual dosage of natural hormones, cleaned up my eating act, and got back on track. It took two weeks to get back to normal. The lesson learned? I'm fifty-two, my body cannot tolerate coffee, and I have to listen to it if I want to feel good. The lesson relearned? The balance of hormones is precarious, and one small thing can set off a domino effect, pushing everything out of control.
The 30-Day Plan will help prevent the dominoes from falling and robbing you of precious wellness time. By following the advice in these pages, you will be able to quickly identify the culprits that disturb your hormone balance. By the time you're finished with this book, your hormones will no longer be a mystery, and understanding how to help maintain their balance will be second nature.
MENARCHE TO MENOPAUSE-WHO SUFFERS FROM HORMONE IMBALANCE?
While preparing to write The Hormone Solution, I reviewed the records of five hundred patients (covering the years 1997 through 2001) in my own practice, looking at the age distribution for women with diagnoses related to hormone imbalances. The demographics revealed an almost even distribution between menopausal women and women ranging in age from sixteen to forty-five.
The results seemed unusual, but I was sure I wasn't misdiagnosing these women. They all had thorough and complete medical evaluations and blood tests from other doctors before they came to me. Their extensive and expensive workups confused and scared them, but offered them no solutions. But when I put them on my 30-Day Plan and began balancing their hormones, their symptoms consistently disappeared.
Which led me to ask: How often do symptoms of hormone imbalance in young women go unnoticed and undiagnosed in the general population? Clearly these young women were not aberrations. They were suffering with severe premenstrual syndrome (PMS), bloating, breast tenderness, mood swings, loss of sex drive, hot flashes, and night sweats. These were serious symptoms and needed to be brought into the open and addressed.
I didn't remember reading any medical literature addressing symptoms of hormone imbalance in populations outside the standard menopause age group. Before I put this surprising information into my book, I decided to review the scientific literature and find out what other hormone experts had found.
I turned to the medical literature looking for statistical data on age distribution and frequency of symptoms of hormone imbalance at different ages. Not only did I find nothing on age distribution, but I also found no adequate information on the presence of symptoms of hormone imbalance in other age groups besides menopause.
Medical textbooks of obstetrics and gynecology, internal medicine, and endocrinology, clinical manuals, medical journals in the United States and abroad, rarely addressed the incidence of symptoms of hormone imbalance in young women similar to those suffered by menopausal women. Few, if any, medical textbooks addressed the connection between hormone imbalances and symptoms such as PMS and depression in young women. The only time that medical literature addressed symptoms and connected them to hormone imbalance was when women were either sick or menopausal.
The first people who connected the symptoms of hormone imbalance (PMS, depression, and so forth) to hormone imbalances were doctors who were not writing medical textbooks or journals- they wrote books and articles that were meant to be read by women themselves. Books such as No More Hot Flashes and Other Good News by Dr. Penny Wise Budoff (1983), Women's Bodies, Women's Wisdom: Creating Physical and Emotional Health and Healing by Dr. Christiane Northrup (first published in 1994), and Screaming to Be Heard: Hormonal Connections Women Suspect. . . and Doctors Ignore by Dr. Elizabeth Lee Vliet (1995) asked women to take responsibility for bringing their knowledge to the attention of their physicians.
Over the years, I have found that popular (nonscientific) literature is sometimes ahead of the medical journals because it needs to be in touch with its readers to survive. But in this case, even the nonscientific literature was difficult to find. With the exception of the above-mentioned books, I found few books written before 1996 that specifically addressed symptoms of hormone imbalance in any age group, not even books on menopause (there was one exception- a book written in 1968 by Robert Wilson, called Feminine Forever, which was sponsored by Wyeth [then Ayerst] pharmaceuticals promoting the rejuvenating effects of its new drug Premarin).
Then, in the mid-1990s, the floodgates of menopause burst open. A tide of literature addressing issues surrounding hormone imbalances in menopausal women swept the consumer market. I read every one I could get my hands on. They all addressed menopause and the symptoms created by the loss of hormones associated with aging. But I found myself wondering why anybody would expect the symptoms of hormone imbalance to just appear out of nowhere around the age of forty-five to fifty. Why would we look at hormone changes in a vacuum, as a sudden incident rather than part of the continuum of hormone changes? Isn't life a continuum?
Back in my practice, I continued to see women of all ages with complaints of hormone imbalance. I became determined to acknowledge and validate the presence of the symptoms regardless of age.
The Hormone Solution was published in April 2002. Since then, I've been seeing even more young women in my practice. They call from around the country and around the world, seeking advice and information. Many have been experiencing undiagnosed severe symptoms for years. Others are just fearful of finding themselves out of hormones in their forties and fifties without preparation. They say, "I don't want to wind up like my mother, suddenly old and sick and overwhelmed by symptoms of menopause."
Once you realize that hormone imbalance can occur at any age, you can take a proactive role and learn to identify the symptoms, connect them to hormone issues, and then treat them following a thorough and all-inclusive program. My research enabled me to break down frequency of symptoms according to age into five major groupings.
LIFE CYCLES AND HORMONES
From puberty to menopause, our bodies constantly manufacture hormones. There is always an ebb and flow of hormonal activity going on, often in cycles. The most familiar of these is the menstrual cycle. There are, however, other equally important cycles that impact our hormone balance, some of them internal and some external.
The internal cycle most readily known and studied is the regular (or irregular) monthly cycle our bodies create to keep hormones in balance and help us perpetuate the species by making young women fertile every month. Menstrual cycles vary during a woman's life span. Menstrual regularity at twenty-eight to thirty days is the norm, but statistical data on frequency and cycling of menstruation show enormous variation. Although we rarely read these facts, it appears that menstruation cycles vary from fifteen to sixty to ninety days in women without any diagnosed illnesses or problems with conception. A growing school of thought affirms that regularity of the menstrual cycle is unimportant as long as fertility is unaffected.
The only problem with unpredictable periods is in the area of pregnancy prevention. Ovulation, and the forty-eight hours of fertility that ensue, occurs fifteen days before the next menstruation. The main reason that relying on rhythm method for contraception doesn't work is that, because the number of days in the menstrual cycle isn't consistent, you can only guess at when it's fifteen days before your next period. Birth control pills prevent ovulation and override the woman's normal cycle by creating a synthetic, externally induced cycle of twenty-eight days. No ovulation, no pregnancy.
The question is, how healthy is this for the normal internal cycle? Science has no answers yet. Research is sparse, and little is being done to my knowledge to investigate the issue further.
External cycles are mostly life cycles. Environmental temperature and seasonal changes, for instance, often translate into serious hormonal changes. The thyroid gland, our internal thermostat, helps us adjust to heat and cold. Modern society has altered the natural hormonal transition involved in the seasonal changes through air-conditioning and central heating. Sudden temperature shifts often affect our cycles and create problems we are not even aware of.
Becoming aware of the effect of external cycles and sudden changes becomes important in our quest to understand what throws our hormone balance off and when. The better the grasp we have of the cycle we're in at any given time, the easier it is to follow the program to keep our hormones in balance and prevent serious illness.
Patients often ask, "How do I know if my hormones are balanced?" When your hormones are in balance, you feel well. And typically, you have energy and don't crave salty or sweet foods. Your weight is stable, and your sleep pattern is consistent and uninterrupted. When you wake up in the morning, you are well rested and raring to start another day. You feel and look young and healthy.
Perhaps the above picture doesn't quite represent you. You don't feel quite that well, you suspect your hormone balance might be off, and you'd like to get a professional opinion on whether or not your hormones are in balance. Then you might ask, "How do you measure hormone balance?"
Unfortunately, present methods of testing, in my opinion, make it impossible to gain valid tests that offer realistic insights into our hormone balance. There are some blood tests that can measure individual hormones such as thyroid and testosterone. While estrogen and progesterone levels can also be measured, these measurements do not reflect the presence or absence of symptoms.
We have no tests to help us extract usable information that connects blood, saliva, or urine levels of estrogen and progesterone to symptoms of hormone imbalance.
This makes it difficult, to say the least, to grasp the intricacies of balancing hormones.
Without being able to measure them or see them, how can we connect them to such obvious and unbearable problems as hot flashes, night sweats, depression, and loss of libido? The only information we can rely on comes from the medical subspecialty of endocrinology. Unfortunately, endocrinology focuses on illness, so most of the information we have is about hormonal behavior after we've become ill.
So for now, there is no scientific answer. Until reliable tests are developed and proven to work, we are left to decide on our own and with the help of our physicians whether our hormones are in balance or not. Because I have found that no existing blood, urine, or saliva test can encompass the scope of hormone fluctuations inside the human body, I believe that subjective measurement is today the only reliable method of measurement for hormone balance- in other words, it's vital to learn to read and listen to your own body's messages.
What our bodies tell us and what we want to hear are not always the same thing. We Americans are not experts at reasonable expectations. We are a nation developed from the philosophy of pushing the envelope. Many of today's health and wellness problems stem from this mentality. We believe nothing is impossible, which has allowed us to become the most highly developed country in the world, with the highest life expectancy. But we can push the limits only so far. Our bodies are not as evolved as our minds. If we want to survive into advanced age in good balance and with minimal infirmity, we must learn to listen to our bodies-within reason.
What is reasonable at fifteen may be crazy at forty. And what is reasonable to a man is not necessarily reasonable for a woman. We must learn whether our hormone balance is in concert with reasonable expectations. And we must understand that reasonable expectations must be considered before alterations to our hormone balance are undertaken.
Mark was sixty-eight when he came to see me. He wanted to regain some of the vim and vigor he had enjoyed earlier in his life. He had read about testosterone improving stamina in males and wanted to try it-not so much for sexual enhancement as to improve his skiing. As unusual as the request might sound, it's common for me to see patients who have specific problems that they expect hormones to solve. After evaluating his blood tests, testosterone levels, and prostate-specific antigen (PSA) levels, and receiving a clean bill of health from his primary physician, I prescribed Mark 20 mg of micronized testosterone in cream form for three months.
When he came back to see me for a two-month follow-up visit, he was ecstatic. His skiing had improved, and his sex drive had picked up speed. A blood check confirmed a rise in his testosterone levels. Mark was on a roll.
Unfortunately, his good luck came to a crashing halt halfway down a double-black-diamond slope. Mark had relied too much on hormones to improve his performance, and not enough on practicing his skiing. He skied beyond his ability, broke his thighbone, and required major surgery. Recovery took six months; he lost a whole skiing season and was left with a permanent limp.
Mark is a perfect example of unreasonable expectations. Although testosterone was a great boost, it could not make his sixty-eight-year-old body twenty years old again. Mark should have used the improvement in his well-being to improve his muscle strength and build better resistance and balance rather than increase his speed and reckless behavior on the ski slopes.
Looking at Mark's example, we realize that balancing hormones
alone is not enough. That's why the 30-Day Plan gives you more
than the prescription for natural hormones you need to obtain improvement
in your hormone balance. It will help you identify and
then use your personal state of homeostasis in concert with reasonable
expectations to help you achieve long-lasting health, vitality,
and great quality of life.
Excerpted from The 30-Day Natural Hormone Plan by Erika Schwartz, M.D.. Copyright © 2004 by Erika Schwartz, M.D.. All rights reserved. Posted with permission of TWBookmark.com. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.