Hormonal HealthHormonal Health

The Hormone SymphonyThe Hormone Symphony

Mark Burger, Pharm.D.Mark Burger, Pharm.D.

Health First ! PharmacyHealth First ! Pharmacy

““Why Zebras Don’t Get Why Zebras Don’t Get Ulcers”Ulcers”

Book by Robert SapolskyBook by Robert Sapolsky A primatologistA primatologist Zebras don’t get ulcers because they run Zebras don’t get ulcers because they run

away from stress (lions)away from stress (lions) Modern humans can not run away Modern humans can not run away

(mortgage, commute, relationships, (mortgage, commute, relationships, money, career, aging parents, etc.)money, career, aging parents, etc.)

NIH NIH : 90% of : 90% of ALLALL illness is stress-related illness is stress-related… … so modern humans are so modern humans are

constantly stressed ! (and get constantly stressed ! (and get sick from it)sick from it)

Autonomic Nervous System

• 2 Parts: Sympathetic & Parasympathetic

• Excitatory vs. Calming• The 4 ‘Fs’: Fight, Flight, Fright, Sex• Calm, vegetative, & everything BUT 4Fs• S: Dilated pupils, Dry mouth, Rapid

Heart rate, Indigestion, High cortisol.• P: Constricted pupils, Salivation, Slow

HR, Digestion, Sexual arousal.

Stress Hormones

• Adrenaline and Noradrenaline (British)• Epinephrine and Norepinephrine (US)• Glucocorticoids (cortisol) from the adrenal glands [they sit on

top of the kidneys]• Stress > Glucagon Glucocorticoids

Glucose

(sugar)> Prolactin (depresses libido) Testosterone

Progesterone Estrogen Human Growth Hormone

• Male Stress Response: Fight or Flight• Female Stress Response: Tend and Befriend

Effects of Stress

• Cardiovascular Events (Heart Attacks, Strokes)[Blood clots more easily]

• Diabetes (elevated blood sugar, insulin resistance)• 67% of people get Hyper-phagic (eat more)• The food they crave is starch, sugar & fat• Increase storage of food (energy for survival) especially

around the abdomen *Apple Shape*• Shut down of digestive processes (no saliva, no peristalsis,

no enzymes, no absorption, no bloodflow)• Suppression of the Immune System (long-term)[Improved in short-

term]

• Memory loss, Alzheimer’s, Brain damage, Depression• Osteoporosis, Fatigue, Hair loss, elevated TGs, Anxiety

Free Radicals > Cell destruction, HD, RA, Alzheimers, Wrinkles, CA

Hormonal Effects

• Definition:“Functional Hormone Imbalance”

• When the level of the hormone is “normal” but symptoms of deficiency or excess are present

• Examples: 1) for Estrogen (E) to work, there must be some progesterone (Pg) around to allow expression of E-receptors;

• 2) Pg can attach to a Cortisol (C) receptor almost as well as C itself; 3) Pg blocks the C-induced build up of Aromatase (T>E) enzyme in fat tissue; 4) Pg competes with Testosterone (T) for the 5-alpha reductase enzyme (prostate problem causer); 5) Cortisol (C) competes with Pg at Pg receptors therefore High Cortisol (stress) = Estrogen dominance (fibroids, endometriosis, breast fibroids, breast cancer, PMS, irregular periods, infertility)

Hormonal Effects (cont.)• Cortisol (the stress hormone) opposes the effects of DHEA and

Testosterone• Cortisol suppresses the production of T• Cortisol competes with T at the DNA level• Cortisol induces T > Estrogen = loss of libido, estrogen

dominance, weight gain, loss of muscle, blunted motivation, BPH

• Cortisol is permissive for the action of T-3 (thyroid hormone)• Elevated C reduces TSH and free T3, shunts T4 to rT3 (bad)• Elevated C reduces Pg in endometrium and increases Estradiol• Elevated Estradiol competes with T3 at receptors (functional

hypothyroidism)• Elevated Estradiol competes with Testosterone• Elevated E produces more Sex Hormone Binding Globulin

which binds up free Test. (functional hypogonadism) & free T3

Notice how very close these hormones are in structure!There are only 2 double bonds and a Hydrogen atom differencebetween Testosterone and Estradiol.

Hormone Effect (cont.)• DHEA opposes Cortisol effect (if low cortisol, giving DHEA

could make you worse off)• T3 (thyroid) stimulates Pg release from ovarian cells• Mild hypothyroidism has been associated with infertility and

hirsutism (excessive hair growth)• Too much insulin can lead to PCOS (polycystic ovarian

syndrome): Weight gain, hirsutism, elevated testosterone, insulin resistance, infertility (in women)

• Coffee, Alcohol, lack of exercise & insufficient sleep lead toCortisol (1 cup of coffee raises cortisol for 48 hours!!)

•…so you can see how hormones affect each other!

How do we test cortisol?

• Saliva cortisol done 7AM, 12N, 5PM, 10PM• Diurnal rhythm looks like this:

7AM 12N 5PM 10PM

If it is elevated in the AM, then we may have difficulty staying asleep

If it is low in the AM, we may have difficulty getting started

If it is low at bedtime, we may not be able to “turn off” our brain and go to sleep

Typical Cortisol Response Patterns (some examples)

• Elevated in the AM (can’t sleep), tired in the afternoon, wired at bedtime

• Depressed in the AM (need coffee), elevated in the afternoon (best time of day), elevated at night (can’t sleep)

• Normal in the AM, low in the afternoon (need caffeinated sodas), elevated at 5 PM (best part of day), too low at bedtime (tired but wired)

What Can We Do?

• You can test your cortisol levels• You can get a better job/relationship/

commute/mortgage/sleep/etc.• You can eat better (more protein, eat

breakfast, chew your food)• You can take supplements (Zinc,

Chromium, Boron, Vit. B-6, Vit B-5, Selenium, Vit. C, Folic Acid, Vit. B-12)

What Can We Do? (cont.)

•Supplements (cont): Adrenal extracts, Adaptogens (e.g. maca, relora, ginseng, rhodiola, licorice, ashwaganda, holy basil)

• Meditation (breath work, yoga, etc.)• AVOID: Heavy metals (arsenic, lead,

cadmium, mercury)

Conclusion• When evaluating your hormone balance, you can not ignore the

effects of stress and cortisol• When considering hormone replacement, always test the cortisol

levels• Realize that as your stress level changes, your hormone balance will

be affected … either way!• Always take care of the adrenal glands FIRST (or concurrently with

other therapies)• Look to fix the thyroid gland AFTER you have healed your adrenals

and have achieved relative hormone balance in regards E, Pg, T, DHEA.

• Realize that the adrenals didn’t get out of whack in one week, so don’t expect to heal them in a week … it takes time to heal!

• Don’t depend on supplements ONLY! Look to your diet. Evaluate your eating patterns. Look to your lifestyle. Look to your body burden of heavy metals, parasites, infections (stressors!)

• Realize that Adrenal Fatigue is REAL and that it is THE 21st century affliction (80% of us have it, 20% of us are in denial about it)

Why the Badger?Aggressiveness, Reliance, Self-Expression

The power of the Badger totem is its aggressivenessand the willingness to fight for what it wants.This aggression can also be turned to healing - for Badger is the keeper of Earth's healing herbs. 

Badger people are quick to express their feelingswith concern for the consequences.  They are often healers who have the courage to use unconventional methods.Badger has the ability to persist to find a cure.

Badger people are often leaders and bosses, the one who will get the job done.

If you have a Badger as a totem, you will likely be solitarybut comfortable being alone.You are comfortable within yourself and very self-reliant.

Badger anger can get you out of apathy,but be careful not to cut yourself (or others) to ribbons using.Badger is a powerful totem when used properly.

The End … for now