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Dr. Thierry Ertog is the President of The World Society of Anti-Aging Medicine, author of numerous books and scientific publications on the topic of youth returning, consultant on anti-age therapy from leaders of the world economy and politics, business and art.

Hormone Therapy: Questions and Answers

Hormone therapy in preventive medicine

Modern medical studies and long-term experience indicate clearly that the path to health and youth lies through highly qualified correction of human hormonal balance. Here Dr. Thierry Ertog answers the most frequently asked questions. He debunks myths and reveals benefits of hormone therapy to solve many problems faced by modern human.

The word “hormone” comes from the Greek language and means “messenger”. Hormones are chemical substances that synthesize a special kind of tissue – an endocrine gland. Hormones secreted by the endocrine glands into the blood in most cases are interconnected with transport (plasma binding) proteins and in this form are carried by the bloodstream to other tissues or target tissues. Hormones activate (or inhibit) target cells in target tissues binding to specific hormone receptors, which may be located both on the surface and within the cell. Each hormone of different type has specific, peculiar only to it, useful feature that can manifest itself as pleasant feelings or physical feature.

Bioidentical hormone is a chemical substance that has the same (identical) structure as the corresponding hormone produced by human. In other words, it is 100% human hormone. Hormone receptors (proteins, connection with which makes hormones exhibit useful properties) of target cells (cells, which are subject to useful properties) are fully adapted to the perception of this form of substances that are identical to natural hormones of the human body. Intake of bioidentical hormones in small doses generally is not accompanied by side effects that may be observed at an excessive dosage.

Two types of bioidentical hormones are used: natural hormones that are produced in animals, so a thyroid hormone obtained from the thyroid gland of pigs, bulls and sheep is used; and synthetic hormones which are created in the laboratories of pharmaceutical companies from plant material. For example, most of bioidentical estrogen, progesterone and androgen are created from precursors found in the American potatoes (including batat).

Nonbioidentical hormone has a structure different from the corresponding human hormone. The structure of these substances is not fully adapted to the human hormone receptors. In some cases nonbioidentical hormone can bind to a receptor for a very short or, conversely, a long term (without the ability to detach from the receptor by itself) that affects the degree of activity of the hormone. The difference between the structure of these substances from natural analogues produces side effects that are observed even at very low doses, even if there are no obvious complaints.

There are two types of nonbioidentical hormones at doctors` disposal: natural hormones of animal origin, such as estrogen, extracted from the urine of pregnant mares; and synthetic hormones that are invented in the laboratories of pharmaceutical companies, and which have from very beginning modified structure for a more evident specific effect and/or to obtain a patent.

The impact of bioidentical hormones on the mind and emotions unlike nonbioidentical substances characterizes by mostly positive results, especially in dealing with anxiety, irritability, depression and fatigue. On the contrary, to achieve some somatic effects is easier with the help of nonbioidentical hormones. Synthetic derivatives of cortisol cope better with inflammation than the human cortisol, because they have longer duration of effect. Similarly, synthetic progesterone derivatives (progestogens) generally are more effective when excessive menstruation than natural analogue as it is metabolized (destroyed) more slowly.

Since bioidentical hormones do not differ from the natural joints of the human body, doctors give them preference: they are better perceived by the body, they often provide more stable effect and have a much lower level of risk than nonbioidentical hormones. However, the risk of overdose and balance disorder in the endocrine system when taking bioidentical preparations can be comparable with the side effects of using of nonbioidentical synthetic derivatives of hormones if a deficit of not all, but certain hormones was adjusted or when a dosage was selected incorrectly.

A treatment with the use of hormone additives (estrogen, progesterone, thyroid hormone, cortisol, testosterone, DHEA, melatonin) is called hormonal therapy.

Each of us is unique, with a special, only to him (her) inherent hormonal and nutritional profile. For most women the period of optimality condition of the endocrine system occurs between 18 and 23 years, and for men – between 21 and 25 years. At this time levels of most hormones usually reaches peak value. Having reached the optimality condition, hormone level of young people remains the same up to 30 years. With this age slow at first barely noticeable decrease in hormone concentration begins, which by 40 years shows already clearly.

It is recommended for most people to pass the initial medical examination during the optimal operation of the endocrine system: for women – between 18 and 23 (years) and for men – between 21 and 25 years, and the doctor must carefully monitor the level of hormones and nutrients. Serious hormonal disorders rarely occur at this age, and indicators of the concentration of hormones can be considered optimal or near-optimal for health, so later they can serve for standard in case of deficit occurs.

Here are a few factors that contribute to disorders in the endocrine system:

1. One of the main factors contributing to the reduction of hormone production is inexorably progressive aging of tissues, called endocrine glands, where the synthesis of hormones occurs. The glands get tired and weaken, eventually wear out and does not cope so well with cell renewal, which are replacing the dying one. The situation is also exacerbated by the fact that the cells that have retained their function, start to find difficulties to produce hormones, because their activities are impeded by the accumulated decay products and the lack of enzymes.
2. Improper diet can cause hormone deficiency or aggravate an existing condition. Unhealthy diet deprives endocrine cells of substances which are necessary for renewal and production of new hormones such as minerals, vitamins, major mineral elements, amino acids and cholesterol. Such diet disturbs the functioning of endocrine glands. The latest craze of diets with low fat or protein (vegan or vegetarian) leads to the fact that the body does not receive certain types of fatty and amino acids, which are used in the synthesis of sex hormones and adrenal cortex hormones, growth hormone and many others.
3. The frequent infections by viruses, bacteria, fungi and/or parasites gradually destroys and attenuates the endocrine system.
4. The source of the toxins can be not only the environment (both indoors and outside, including electromagnetic radiation) but also food (pesticides, heavy metals) can reduce the activity of the endocrine glands. The stereotype of diet typical of the West, for example, overloads the glands of internal secretion with toxins, which are abundant in burned-out fat and chlorine (in tap water). These toxins accumulate in the endocrine glands and disturb their functioning.
5. Hormone deficiency of some people can be due to the peculiarities of genotype, which causes dysfunction of the endocrine glands much faster than that of the other members of the population. Hormone level of each individual sooner or later drops below normal for health. However, there are drugs that can compensate for the hormone deficiency, and it is really a good news.

Given the fact that the lack of nutrients or hormones can be diagnosed at birth, caused by genetics or improper nutrition of the mother during pregnancy, lack of hormones and/or nutrients are sometimes prescribed immediately after birth.

Most children and young people do not need (yet) replacement therapy, since their level of hormones is normal. However, in our modern society more and more young people eat incorrectly and do not sleep enough, which causes premature malfunction of the endocrine glands, requiring treatment.

In our experience, most people require hormone therapy at the age of 30 to 45 years, during this period the deficit of hormones begins noticeably to show.

In fact, the aging in the light form due to a gradual decrease in hormone level begins at the age of 25 – 35 years and becomes visible by 40, 45 or 50 years. The speed of the hormonal decline varies for each person, but sooner or later it is bound to occur with each person, and a need for replacement therapy arises.

Note: Perhaps in the future scientists will invent methods of early diagnosis of microscopic deficiency of hormones in newborn children in order to prescribe the appropriate microscopic dosages of missing hormones, providing thus the best conditions for development. But while it is beyond our power.

As for dietetic treatment, we believe that in order to normalize the hormone level it is required for everyone, even children.

May one take nutritional and hormonal supplements temporarily but not permanently? Most dietary supplements should be taken only from time to time, within a certain period, but not always. While hormone therapy means, as a rule, a permanent intake of drugs.

In fact, at any age a human has difficult periods that require additional amounts of minerals, vitamins and hormones. To compensate for the temporary states of deficiency, supplements can be prescribed for a limited time. Chronic stress, for example, generally increases the consumption of hormones, thereby reducing their production. This dual depletion leads to a temporary, but sometimes serious hormonal deficiency, which can lead to premature aging.

Serious food deprivation, as during anorexia nervosa in adolescents, also leads to a temporary decline in the level of hormones and may require hormone therapy and intake of nutritional supplements, in order to avoid premature aging and health problems. Occasional consumption of sugar, refined carbohydrates and alcohol, products not intended for human body, instantly reduces the level of many of the major hormones and potentially accelerates aging, if these products are not excluded from the diet, and hormone level is not restored. Tobacco smoking, drug addiction, infectious diseases, pollution, (too) intensive sports also weaken the body and may require temporary compensation with the help of hormone therapy.

While the deficit is persisting, daily intake of hormones and dietary supplements is still needed. Whenever patients manage to improve their lifestyle and eating style, and these improvements restore balance to the optimal or near-optimal state, dietary supplements are unnecessary and there are no need to intake them.

Hormonal supplements still have great value in most cases, because only light, not heavy or moderate deficiency of hormones could be corrected with the help of lifestyle improvement and dietary changes. Improvement of lifestyle and nutrition is seldom effective enough to make the consumption of hormone supplements completely superfluous.

So, dietary supplements are usually needed only temporarily, while hormone replacement therapy involves daily intake of drugs during the whole life, as a hormonal deficiency can not be corrected by itself.

Note: The patient can always terminate the hormone therapy. At the same time in a week or two the origin (low) hormone level will renew. Intake of bioidentical hormones in physiological doses does not inhibit the functional activity of the glands and does not damage them. In 9 out of 10 cases after termination of therapy hormone level did not fall below the original. Even after termination of thyroid hormones therapy, which lasted for 20 years, the level of hormones secretion renewed completely during the initial few weeks, which is surprising, since under normal aging the gland must have significantly weakened during this period.

Many people assume that low hormone level of elderly people is a normal adaptation to aging. But this contradicts the available facts. A low hormone level is not able to prevent any death or illness of old age. In contrast, a low hormone level facilitates the development of various disorders and accelerates premature aging and death.

Why? The answer is simple. The body of elderly people has approximately the same size and weight as during their youth. It needs the same level of production of hormones that in earlier years but not decreased one as in old age.

In fact, most people have the best possible state of health during the period from 20 to 30 years. At this age, hormone level is optimal for health, well-suited to the size and volume of the body. This level should be high enough for the normal state of health. Any concentration decreasing of hormone level in the blood provokes a state of deficiency in the organs that violates their functionality and leads to disease. Whereas the intake of hormones during deficiency contributes to the restoration of health and wellness.

The assumption that the natural order of things is the right and the decrease of hormone level with age helps prevent cancer, cardiovascular and other diseases, is fundamentally wrong and refuted by many scientific works that show the opposite:

 The frequency of development of cancer and cardiovascular diseases is much higher in the older age group, where the level of hormones of patients is below than the level of young people.
 Research studies of many hormones have shown that a low level is associated with the development of age-related diseases and often with an early death. This is true not only for the heart and vascular diseases, cancer, diabetes, obesity, osteoporosis but for many other diseases.
 Other research papers have demonstrated that patients treated with hormonal therapy for compensation of deficiency, the incidence of many (age) diseases and in some cases mortality has been reduced.

Properly provided hormone therapy has a number of useful benefits. At the appropriate level of therapy monitoring, the use of specially selected doses for the certain patient, competent and experienced physician – all this helps to achieve the desired results.

The main advantages of hormonal treatment include:
  1. Improvement of health and quality of life
  2. Improvement of emotional well-being and mental balance, a significant reduction in the frequency of occurrence and severity of depression, anxiety, fatigue, etc.
  3. Appearance rejuvenation
  4. Improvement of performance in sports and at work
  5. Improvement of relationships in the family and society
  6. Sleep improvement
  7. Improvement of health and functions of tissues and organs, preventing the development of disease
    1. Improvement of heart and blood vessels, reduction of the risk of cardiovascular diseases
    2. Improvement of the immune system, reduction of infection
    3. Improvement of the pancreas, reduction of the risk of diabetes
    4. More efficient metabolism and homogeneous distribution of fat in the body, reduction of the risk of obesity
    5. Improvement of the brain functioning, reduction of the risk and progress slowing of Alzheimer’s disease and other brain diseases
    6. Partial prevention of cancer (such cancers as prostate cancer and breast cancer, as well as cancers of other organs)
  8. Reduction of treatment costs
  9. Life extension (longevity, increase of healthy years with high quality of life)

The list of all possible useful properties may be too long to list it entirely herein. However, the key word is still “possible”, since any type of hormone therapy can not guarantee the existence of the entire set of the above-mentioned properties. Each type of therapy promotes some of them, but not all. In addition, expression of useful properties is observed mostly in patients suffering from lack of hormones, as well as in those who adheres to all the requirements of a doctor.

Hormone therapy removes unpleasant feelings such as constant fatigue, periodically occurring anxiety, worsening of depression, which arise mainly because of hormone deficiency.

Hormone therapy removes unpleasant feelings such as constant fatigue, periodically occurring anxiety, worsening of depression, which arise mainly because of hormone deficiency.

 The lack of thyroid hormones causes morning fatigue, the peak of which falls on the wake-up time, in addition it returns during the day while each interruption of the activity. The mood is also usually low in the morning. The intake of thyroid hormones eliminates these symptoms, providing upbeat and cheerful mood in the morning. Thyroid hormones stimulate the mitochondrias – the small grain of energy – they begin to produce more ATP and NADPH, which molecules store energy and release it in case of need. Thyroid hormones also stimulate blood flow in the arteries and thus improve access of oxygen and nutrients to the target tissues.
 Cortisol is a hormone that also stimulates the production of energy by
 accelerating blood flow, improves the supply of oxygen and nutrients to the cells.
 increases glycogen in muscle and liver. Glycogen is a large size molecule that includes many compounds, sugar precursors which provide energy for the body.
 It stimulates the production of sugar from glycogen and amino acids. By increasing the level of energy, cortisol removes the feeling of stress and fatigue and disorientation, the typical complaints because of lack of cortisol that occur in stressful situations. Cortisol gives a feeling of freshness and vitality, enabling the individual to cope better with difficult situations.

 Treatment with the help of growth hormone and androgens can improve recovery from workouts, and help people feel better in body and soul whose activities are connected with heavy physical exercise. Both hormones stimulate the parasympathetic nervous system, which calms the individual, eliminating the feeling of fear. The growth hormone eliminates anxiety, giving a sense of inner peace. Androgens make a person more courageous; more confident.

 Female hormones such as estrogen cause sudden bursts of energy and excitement, transforming partly into catechol estrogens – a kind of adrenaline (epinephrine), which stands for emotional outbursts in women. Estrogens effectively cope with depressive states caused by the lack of female hormones, for example, as a result of menopause.

 Melatonin restores energy reserves, improve sleep: the person falls asleep faster, sleep through the night, all the muscles relax – all these factors contribute to a better recuperation.

In short, a variety of useful properties of hormone therapy explains the improvement of quality of life and state of health, which many patients testify.

Some patients at the first consultation say that they do not want to rejuvenate and simply want to feel themselves better. As if the desire to look younger has something shameful. These people want to rejuvenate from the inside, that is, simply put, improvement of health, but in fact they flatly refuse to improve their appearance. Their desire is not feasible. Proper hormone therapy improves as the appearance as “internal health” of people with hormonal deficiencies.

The appearance is an excellent indicator of the effectiveness of hormonal therapy, because it indicates the state of health. Besides health improvement the appearance also improves, progress is noticeable on the body and face.

The consulting physician should try to achieve improvement of the face and body, which is an indicator of the effectiveness of treatment. How does hormonal therapy contribute to that?

Each hormone stimulates different effects on the organism. Lack of thyroid hormones, for example, causes the accumulation of harmful substances (mucopolysaccharides) in tissues, causing them to swell. Edema due to mucopolysaccharides action is called myxedema. Because of hypothyroidism (lack of thyroid hormones) the face looks puffy, the lower legs swell and the further development of the disease reduces the rate of fat breakdown, allowing the fat to accumulate in the abdomen and thighs. The abdomen swells due to slow digestion and reduce of gastric acid production, and as a result the upper abdomen increases due to accumulation of undigested food in the stomach. Essentially the entire abdomen swells due to retention of food in the bowels caused by defecation complication. Fermentation of bacterial and fungal flora in the undigested remains of food causes the formation of intestinal gas that causes the abdominal cavity to swell even more. The lower part of the abdomen of patients with hypothyroidism may swell even more due to the accumulation of stool in the rectum due to constipation. The intake of hormones thins the lines of the face, thighs and body by speeding up the removal of waste from the cells. The therapy also contributes to the loss of overweight, makes it easier to get rid of excess kilograms. Swollen feet and ankles gradually deflate as hormone therapy makes the kidneys excrete more water in the urine.

Other hormones also contribute to the renewal of body contouring. Androgen (male hormones) and growth hormone treatment makes the body more muscular and tough. The hand muscles become stronger. The stomach flattens as growth hormones and androgens contribute to the removal of fat and cellulite elimination. The loss of muscle mass with aging, but actually as a result of hormone deficiency, stops completely or partially.

When intake of growth hormones the large facial wrinkles caused by lack of the hormone, such as the frontal wrinkles and nasolabial folds, coming down from the nose to the corners of the lips, smooth, become less visible and may even disappear. The sagging cheeks harden, as the cheeks muscles become stiffer.

The lack of estrogen and testosterone stimulates the formation of small vertical wrinkles above the lips of women during menopause, as well as of many women aged from 40 to 50 who have still had menstruation. The intake of estrogens and androgens generally make them disappear in six months or a year in the case of a sufficient dosage.

The lack of vasopressin provokes little folds of skin, in fact, small wrinkles on the forehead and around the cheeks, as well as “crow’s feet” at the outer corners of eyes. Vasopressin treatment reduces the skin folds, formed by hypohydration (lack of water in the body), sometimes up to extinction due to the retention of moisture. In some cases, the intake of fludrocortisone, a synthetic derivative of aldosterone (another hormone responsible for fluid retention) may also contribute to the disappearance of the “crow’s feet”, which are formed due to lack of vasopressin and aldosterone.

The intake of insulin and cortisol by patients with deficiency of these substances in the body helps to cope with excessive thinness and sunken cheeks, filling the body with vital energy. However, gross people who undergo cortisol therapy receive the opposite effect: the body becomes thinner due to lower cravings for sugar and carbohydrate-rich foods.

Hormone therapy contributes to prolonged improvement in professional work, which you are interested in or which brings in returns. The energy level increases by increasing the synthesis and utilization of ATP and NADPH molecules, the main energy wires in the body. Many of these hormones improve stress resistance, which facilitates many complex working moments.

Cortisol and growth hormone, for example, increase the concentration of sugar in the blood, which increases the availability of glucose to the cells, giving strength to fight with stress, and potentiation of the work of the parasympathetic nervous system calms and gives confidence, leaving no chance of anxiety and fear. In addition, cortisol raises morale, causes the desire to test yourself, to face difficulties and overcome them, rather than avoid them, whereas growth hormone promotes clear thinking, helps to find a way out of difficult situation.

Sports and other leisure activities come much easier with the right use of hormone therapy, which will give strength to a favorite pastime and give a good mood. In addition, growth hormone and androgens contribute to sports training, accelerating the development of muscle.

When a serious deficiency of hormones, the patient is not able to exercise or perform the duties properly, as he always experiences fatigue, lack of strength and depression. The intake of hormones can return a person to the usual level of activity at work, in sports and in life in general.

Melatonin and growth hormone improve sleep even in stressful situations, enabling to be in good shape the next day, whereas testosterone allows a person to stay active longer without feeling tired. It also allows maintaining high performance in sports and at work.

Some types of hormone therapy make people more sociable, strengthen family ties and relationships with friends. This applies to oxytocin therapy, which helps morose and socially closed people to open to others, to show more love and care, it eliminates hot temper and irritability, as it eliminates the key reason of the low level of social interaction – the lack of hormones.

Severe deficiency of growth hormone can make people stay at home, as in the shelter, because communication with other people and the world itself generally causes stress and exhaustion, irritates and spurns. Growth hormone treatment returns a person back into society and restores old skills of communication and interaction; people are easier to open, tolerate calmly emotional distress and difficulty, because they receive extra energy to do so.

Sex hormones are hormones of love. The intake of sex hormones enhances both romantic and purely physical attraction between partners. Cortisol deficiency provokes irritability, mistrust and suspicion towards others, absurd behavior and cavil, and in some cases, there are nervous crisis caused by sudden adrenaline rush. Adrenaline is released to compensate for a lack of cortisol, but is capable – at peak concentration values – to cause transient, lasting for 2-3 minutes, madness, panic or aggression. The intake of cortisol or one of its derivatives eliminates irritability and significantly reduces the number of such adrenaline rush.

Thus, a normalization of hormone level enables us to get closer to others: spouses, children, parents, friends and acquaintances.
Many couples have managed to overcome their differences and quarrels through appropriate treatment of one or both partners. But the relationship within the couples, where partners suffering from hormone deficiency did not receive treatment, soured or was repaired with difficulty.

The third of our life is spent in sleep, so a healthy sleep is essential for a healthy life, because it allows to recover and to be ready for a new day.

Melatonin makes it easier to fall asleep. The intake of bioidentical progesterone before bedtime relaxes and makes the person fall into the deep, quiet sleep. Growth hormone treatment promotes rapid transition to a state of deep recuperating sleep. Thyroid hormones and estrogen taken in the morning in the right dosage, increase the phase of deep sleep during the next night (3 and 4 sleep phases).

The key to success lies in the correct dosage selected: neither too much nor too little. The lack or redundancy of hormones can negate all the benefits of the treatment.

Cardiovascular diseases rank the first among the causes of death of the elderly! Growth hormone, DHEA, melatonin, thyroid hormones (in small doses), estrogen, testosterone, insulin (in appropriate amounts) have a protective capacity against vascular and heart diseases.

Some types of hormone therapy can awaken a weakened immune system. Thyroid hormones, growth hormone, DHEA (dehydroepiandrosterone), estradiol, as well as cortisol in small quantities usually encourage the immunity work very strongly.
Thyroid hormone therapy significantly reduces the severity and number of recurrent infections, which are typical for children with deficiency of thyroid hormones. The children who receive therapy can easily survive the winter without a single cold.

Diabetes is characterized by the accumulation of sugar in the blood, making it more viscous and sticky, which hinders flow of vital substances into cells.

The accumulation of sugar in diabetic tissues may be triggered by the absence or deficiency of insulin, the hormone of the pancreas. This kind of disease is called insulin-dependent diabetes or type I diabetes. Redundancy of sugar can also be caused by insulin resistance of tissues, which deliver sugar into the cells. This is insulin resistance diabetes or type II diabetes. In this form of the disease blood may contain excessive amounts of insulin, but it is useless.

The intake of certain hormones, in addition to insulin, facilitates the symptoms of diabetes and reduces the frequency of their manifestation. Thyroid hormones, for example, improve blood circulation and increase pancreatic insulin secretion. The study of diabetics revealed that thyroid hormones also eliminate many diabetes-related health complaints and facilitate the course of the disease, substantially without altering the blood sugar level. Male hormone therapy, testosterone, may suspend developing gangrene, a typical complication of diabetes caused by premature atherosclerosis (artery deterioration) of the lower extremities. Transdermal (through the skin) use of bioidentical estradiol improves glycemic activity of the pancreas, whereas oral intake of estrogen tablets, particularly those with nonbioidentical structure (alien to the structure of the human natural hormone) and associated with a progestogen (not bioidentical, non-human, a derivative of progesterone) may have the opposite, harmful effect.

Alzheimer’s disease affects about 10 percent of men and women over 70. It occurs more often due to short supply of hormones, such as estradiol, thyroid hormones, testosterone, IGF-1 (less IGF-1 of brain receptors), DHEA, melatonin, vasopressin, etc.

On the other hand, treatment with the help of these hormones can produce a favorable effect. Protective properties against Alzheimer are particularly pronounced inter alia in estrogen, testosterone and vasopressin.

Contrary to common belief of the public, doctors and researchers that the hormone therapy “may cause cancer”, hormone therapy does not stimulate the development of cancer. Indeed, several studies have shown the involvement of poorly matched female hormone therapy in development of genital cancers, especially when using nonbioidentical hormones (whose structure is artificially modified and differs from natural analogues in the body). But it is a problem of improper therapy. Many subsequent studies didn’t show risk of cancer growth, and, moreover, many reputable authors argue for reducing this risk.

It is encouraging that almost all researchers say about neutral effect of treatment, and sometimes even about it’s protective effect against recurrence and mortality when the prescription of sex hormones for men and women after breast and prostate cancer, respectively. To our knowledge, only one out of 27 studies showed the opposite effect: increased risk of recurrence of breast cancer when taking (oral) female hormonal remedies! The use of sex hormones by patients with severe forms of breast and prostate cancer can prolong life and improve quality of life.

Using the following guidelines one can significantly reduce the risk of tumors during hormone therapy:

1- Regular medical examination by a specialist with extensive experience in the field of hormone therapy.

2- The use of the most “natural” hormones available in the market, that is, drugs with a chemical structure similar to the natural hormones of the human body, or most closely approximate to it.

Several cases after World War II are associated with the use of artificial hormones, which caused liver cancer, as well as with the use of 17-alkyl derivatives of male hormones, or stilboestrol – estrogenic substance which provoked birth defects of the uterus and vagina, as well as an increased risk of genital cancers in girls whose mothers took this substance during pregnancy. These synthetic compounds poorly imitate the natural hormones, and therefore are not suitable for humans. The pharmaceutical companies have withdrawn dangerous compounds from the sale long ago.

3- Balanced treatment, wherein the levels of all the hormones are in the proper ratio and equilibrium. An adequate balance is a prerequisite of proper female hormone therapy. The attending physician needs to compensate progesterone for the flow of natural estradiol, in order to avoid the risk of endometrial cancer in women with preserved uterus. The risk of endometrial cancer increases dramatically, up to seven times in women receiving estrogen without progesterone. Endometrial cancer is a tumor in the inner layer of the uterine body (the main part of the uterus), and is the only scientifically proven type of cancer, the development of which contributes to the introduction of the hormone estrogen in this case. Several milligrams of progesterone can change the situation, reduce the increased risk. For this reason, women taking estrogen must also take progesterone.

Progesterone also has to be prescribed to women after a hysterectomy (removal of the uterus), to those who take estrogen to prevent painful mammary glands, as well as increase of abdomen, nervousness, anxiety, sleep disorders, etc., associated with the separate intake of estrogen. Bioidentical progesterone or its closest derivative didrogesteron (Duphaston®), is also able to reduce the risk of breast cancer in women. However, the most women who have had hysterectomies, receive on gynecologist`s orders only estrogen who firmly believes that progesterone is necessary only for the uterus, forgetting about its beneficial physical and physiological properties. Sometimes they are wary of the use of progesterone, as have read about the side effects of progestogen derived synthetically from androgens. Such drugs may increase the risk of breast cancer. Do not confuse them with progesterone and didrogesteron, which reduce the risk.

4- Avoid overdoses. Our body is not designed for doping, very high doses of hormones that cause a different kind of imbalance. As with everything, a search for compromise is needed, avoiding excessively small or large doses.

Can hormone therapy prolong our lives? Properly conducted hormonal therapy gives the possibility to live longer, but not forever.

The data obtained from animal studies and some human studies suggest or argue that therapeutic intake of melatonin, growth hormone, DHEA, estrogen, IGF-1, etc. is able to increase life expectancy. Hormone therapy promotes longevity by maintaining health and reducing the probability of occurrence and severity of age-related diseases, such as heart and vascular diseases, cancer and infections, which take the lives of 90% of the elderly people.

How many years can hormone therapy add? Ten, twenty or thirty? Or more? We do not know exactly. According to my calculations, the correct combination of balanced hormonal drugs can prolong life for five – six years, offering at the same time – which is very important – another quality of life.

Hormone therapy effectively improves the general well-being and state of health, is suitable for the prophylaxis of many diseases and partially preserves appearance. Hormone therapy, however, can neither prevent nor cure all medical illnesses.

Some neurodegenerative diseases such as Alzheimer’s disease, amyotrophic lateral sclerosis and certain congenital genetic abnormalities may be difficult to resist hormone therapy despite some improvements in the beginning.

Proper use of hormones allows achieving visible rejuvenation of 3 – 10 years! Today, they can not (yet?) completely reverse the aging of 70 year old person and bring him to look of forty–year-old one. But the sooner treatment begins, the better the results are. It is simpler to maintain the appearance and condition of a still relatively young person, than to try to restore the former years of the old person’s face.

In reality, hormone therapy is not able to completely block the aging. After visible rejuvenation within two – five years (especially when using growth hormone), the aging process is restarted at a lower speed. Apparently, given our experience of examination of thousands of patients, the intake of sex hormones, thyroid hormones and melatonin slows aging by 20-30%. Growth hormone and/or IGF-1 therapy, appointed in addition to the above-mentioned therapy, contribute to slowing aging, which is progressing by 50 to 60% slower than the slowing aging of people of the same age who do not take hormones.

If these assumptions are true, people who receive hormone therapy will die later than older people today, keeping sanity and visual appeal.

Isn`t it too hastily to prescribe hormonal therapy for people with hormone level above the lower limit of the reference value?

No, by prescribing hormones for the patient, doctors do not do to this hastily or rashly. This false impression is due to the fact that experts are trying to cope with all kinds of lack of hormones. After all, attention should be paid not only to the complex cases associated with serious diseases, but to less expressed lack of hormones in which their level is at the bottom of the reference range (but does not lower) that is accompanied by complaints and physical manifestations of deficiency. The aim of hormonal and pro-aging therapy is the optimal health of the patient. Many clinicians, including endocrinologists, ignore patients with similar, mild form of hormonal deficiency.

Incorrect understanding of what is normal or what are reference values of laboratory tests, gives people the false impression that in the pro-aging medicine the hormones are prescribed too often and unreasonably.

Upper and lower limits of normal or reference values in the study of hormones determine not human health, but the statistical limit. Variation of hormone concentration between the upper and lower limit of normal or reference values is called normal range of normal values, which is essentially determined by averaged hormone level in 95% of patients who underwent tests in this laboratory.
2.5% of patients` test results, based on the determination, will overcome the upper reference limit, while 2.5% of patients will have the level of hormones behind the lower limit of normal. That means that out of 100% of patients with suspected hormonal failure, which was the basis for the diagnosis, only 2.5% of them showed a drop in hormone level below the limit, while less expressed (and catastrophic?) hormone deficiency could have been occurred in more than 30 % of individuals. The range of normal hormone test values is too wide to correlate with the actual state of health. But many (reduced, but normal) test results, which patients with hormone deficiency underwent, may affect the calculation of this parameter.

Moreover, each laboratory has its own reference limit in the diagnosis of patients, in fact, of sick people who in accordance with doctor`s suspicion have one or another disease (cause of study). Another observation, which undermines the feasibility of application of the upper and lower reference limits to the hormone level, is that the hormone level changes and decreases with age, although the size and volume of the organs and tissues of aging person remains the same as in youth. Deliberately reduced level of hormones is used for the start point, which is absolutely not justified from a medical point of view, and may subsequently cause a progressive reduction in hormone concentration in the elderly people, and only legal requirement can make the laboratory to bring reference limits in balance with age, separating the age-group.

In order to stay healthy the hormones should come in the same amounts in the body of an elderly person as in the youth, and not in abbreviated doses typical for elderly. The minimum allowable value of the reference range in such cases is also wrongly put too low, this lower limit is mistakenly perceived by many doctors as a border between hormone deficiency and health. Due to the erroneous interpretation of hormone deficiency in aging people usually remains without due attention of the attending physician, who prescribes hormones only in case of a significant breach of the hormonal balance.

Many scientific studies have confirmed that people with hormonal levels 25%, 33%, or 50% lower than the normal value more likely to have development of cardiovascular diseases, diabetes, obesity, osteoporosis, cancer, and in some cases, they are at increased risk of death. This reliable information proves that the reference range of hormone level and its boundaries do not give an objective picture of health, but simply help determine the level of hormones in the other patients (who use the services of the same laboratory).

Thus, any hormone level should be always interpreted and correlated with symptoms and complaints which are related to hormonal disorders, in particular to the deficit. Simplified belief that people with hormone level above the lower limit of normal are completely fine and do not feel shortage of hormones is absolutely wrong. The level of hormones which is in the range between the upper and lower limit of acceptable values, but, for example, does not leave the bottom of one third of the range is considered too low and gives rise to suspicion of a hormonal deficiency, especially in the presence of external signs and complaints. However, other people`s same low-normal hormone level is normal if there are no signs and symptoms of hormonal deficiency.

In most cases, high-quality medicines are used during hormone therapy. Generally, hormone agents are made and sold in official pharmacies that ensure their quality and composition and are dispensed only on prescription. The hormones are recorded as medicaments in pharmacopoeia of the most countries.

The composition, quality and safety of medicines can not be guaranteed for products purchased on the Internet without a prescription. Although growth hormone medicines, for example, can be bought in pharmacies with a prescription, there is a parallel market for these medicines on the Internet and bodybuilding centers. Usually a medicine purchased in such places does not meet expectations, having a very weak effect. There is nothing surprising in this, since these products do not undergo regularly quality inspections by independent organizations. Lack of efficiency is not always due to poor quality raw materials, sometimes there is no a preservative (benziletanol 0.9%) in a test tube, that will certainly lead to the fact that the contents of the test tube will deteriorate and lose the necessary qualities after 2 – 3 hours after its opening. Dr. Thierry Hertoghe faced similar products imported from China. It was needed to take drug eight times more to reach the normal dosage of growth hormone, which is sold in pharmacies officially.
Some time ago, when DHEA only appeared in free sale in the US market, the contents of the capsules was not always consistent with the information on the box.

DHEA is still commercially available in the United States and in most cases the composition of capsules started to meet the label. However, a small experiment showed that the level of DHEA sulfate in the blood of patients who had bought the drug in the United States, after taking DHEA still remained lower than expected.

In short, if you have bought a hormonal drug at the pharmacy, its quality, composition and safety are guaranteed officially. Sometimes in a particular country some kinds of hormone agents may be absent, so one has to order them abroad. In this case, the manufacturer must provide the patient and physician with quality control protocol of the product, provided by the official and independent organization. You should reject any other sources. The manufacturer must provide a product quality certificate.

Can hormone therapy cause irreversible changes in the body?

No, if the patient is under the supervision of an experienced physician and the treatment is based on the following principles:

1- The right criteria of prescription: Hormone treatment is prescribed only to people suffering from a hormonal deficiency, and it is needed a consultation and medical examination, laboratory tests to confirm the diagnosis
2- Adequate range of doses: Using low physiological doses implies that the amount of inserted hormones may be less than or equal to the indicators of physiological norms of production of the hormone by the body of a healthy person per day, so the likelihood of an overdose is markedly reduces
3- Selection of the correct dosage: Pick dose of hormones taking into account the patient’s needs. Each patient requires his own, different from the other, dose of the hormone. Standard dosages of hormones for all patients do not exist.
4- Comprehensive treatment: It is preferably to compensate the lack of essential hormones. In this case it is easier to avoid imbalance between them.
5- Bioidentical hormones: If possible, try to use bioidentical hormones, the structure of which is very close to natural analogues in the human body.

Can anti-aging hormonal therapy and nutritional therapy hold a threat?

These types of treatment use a substance naturally which are producing by the human body for more than one million years, they have proven their value for survival, becoming the object of study more frequently than any of the newly discovered drug already thrown out to the market by pharmaceutical giants. Daily dosing of natural substances are usually small and are selected individually.

Problems and difficulties during the treatment are usually associated with an excess or deficiency of the substance due to poorly matched dosage, and because of poor derivatives of natural hormones. Experts in the field of anti-aging medicine and endocrinology are constantly working at elimination of possibility of errors and malfunctions during the course.

In fact, the majority of hormones can not expose your life to danger. Melatonin, for example, can threaten your safety only if you drown in its solution. Death dosage of melatonin does not exist. Only the intake of fantastically large doses of insulin and thyroid hormones can briefly create conditions that are potentially incompatible with life.

In order to avoid unnecessary risks and to minimize the danger, hormones should be taken with caution like any other drug: to avoid overdose, to take them only on orders of the doctor with sufficient experience in the field of hormone therapy, etc.

There is reason to suspect that statins (lipid-lowering medications: a few dozen?) and stimulators of erection such as Viagra, Cialis, Levitra and others (a few tens or hundreds during the first year of sales of Viagra) claim more lives in a year, than hormonal agents for all use time.

Does hormone therapy stimulate the accumulation of excess weight? No, in compliance with the instructions given below and if the dosage has been selected properly, an increase in body weight is not observed. The intake of growth hormone, HCG and thyroid hormone, in contrast, contributes to the normalization of the weight by reducing the amount of fat. There are four rules below that will prevent the accumulation of excess kilos during hormone therapy:

1- Select the appropriate route of introduction and try to use the best products. For example, the best route of introduction of estrogen to compensate the deficit in women is a gel application with bioidentical estradiol to the skin (transdermal route), which is much safer than swallowing a pill with synthetic derivatives of estrogen (oral route), which, moreover, predisposes to body weight increase.

2- Maintaining the balance between hormones. For example, women with female hormone deficient should not take estrogen without progesterone, otherwise the body will begin to swell, especially the abdomen and breasts. When hypothyroidism (thyroid weakness), women should not take estrogen without thyroid hormones, otherwise estrogens will reduce the level of thyroid hormones that promotes the accumulation of excess kilos. Cortisol treatment requires the prescription of DHEA or sex hormones, otherwise instead of muscles the fat will appear on the thighs and torso. Patients with thyroid hormones deficient, while taking cortisol, must also take thyroid hormones, as cortisol may worsen the situation with the amount of thyroid hormone which facilitates the increase of the body weight.

3- Avoid overdoses: Excessive dosage of estrogen and cortisol can cause obesity.

4- Healthy food. Avoid food products that promote fat accumulation and weight gain, such as sugar, candy, bread, cereals, pasta, milk products, coffee, alcohol and so on, particularly during the treatment with cortisol and estrogens (or with one of its derivatives). These products have many side effects that are dangerous for health and damaging for hormone therapy.

Sometimes some outstanding doctors, not having other expertise of prescription of hormone therapy as to treat diabetes, believe that the treatment with androgens, estrogens and thyroid hormones is harmful to the heart and blood vessels. This point of view has nothing to do with reality, except in cases of taking thyroid hormones in excessive quantities and in cases of the use of certain synthetic substances derived from sex hormones (androgens, estrogens and progestogens). Most products dangerous for health are currently withdrawn from sale.
Properly administered hormone therapy protects the heart and blood vessels. For example, androgens and growth hormones prevent thrombosis as they thin blood, make it more fluid and less viscous. Melatonin also inhibits coagulation. Thyroid hormones stimulate the production of clotting factors in the liver, which contributes to a better coagulation in patients with hypothyroidism, without causing an excessive increase in the number of these factors (in this case the safety is guaranteed).

The rodents subjected to experimental myocardial infarction got their thyroid hormones to have reduced the severity of the attack. Melatonin, growth hormone and estrogen also made easier a course of heart attack in the experimental animals. Thus, patients suffering from cardiovascular diseases may have hormone therapy, provided that the dosage of thyroid hormones must be lower than normal in order to eliminate the excessive stimulation of the heart muscle.

The estrogen in the form of tablets (oral estrogen) increases the likelihood of thrombus formation, as before entering the bloodstream they accumulate in the liver. These depositions provoke liver (so-called ‘estrogen advantage’) to produce clotting factors in large quantities. Androgenic progestogens – structural derivatives of progesterone derived from androgen – and 17-alkyl derivatives of testosterone are strongly not recommended for use as they increase the risk of cardiovascular disease. These substances have a structure different from bioidentical hormones, which is unacceptable. Most of them have been out of the market for a long time.

And finally, both the oversupply and insufficient intake of hormones (e.g. too much thyroid hormones is as bad for the heart, as too little) threaten the health of the heart and blood vessels, while in order to maintain them it is required a right method of route (oral intake of estrogen increases the risk of heart disease, in contrast to transdermal route with the use of gel), maintenance of the balance of hormones (to avoid, for example, the intake of estrogen without bioidentical progesterone or dydrogesterone, its closest derivative), correct drugs preferably with bioidentical structure.

The myth that “hormonal therapy facilitates the development of cancer” sits firmly in the minds of many people. Millions of women and men age from disease and die prematurely due to lack of hormones. Many of them might be suffering from cancer because have not got enough hormones in time.

The four main reasons, as far as we know, have provoked the emergence and popularization of misconceptions:

1. The confusion caused by the various reports of cases of cancer when taking drugs, synthetic derivatives of human hormones, especially sex hormones modifications of pharmaceutical production (androgens, progestogens and estrogens). The structure of these compounds was a (poor) attempt to simulate some human hormones and caused cancer of the liver or kidneys. Pharmaceutical companies have cleared the market of such substances long ago. Despite this, pharmaceutical companies have retained in the annotations to bioidentical and safe synthetic drugs that they sell now a mention of the risk of developing a tumor in the section of contraindications or side effects, although these safe products are not causing any risk. This approach to the annotations provides a legal protection for producers, but it misinforms the public.

2. A false idea of the stimulating effects of certain hormones on isolated cancer cells in the laboratory, but these data are not confirmed by research in the natural environment (‘in vivo’), that is, in living people. With the introduction into the cell of natural hormones, such as estrogen and IGF-1 – molecules performing basic functions of growth hormone, the life cycle of both normal (the immune cells, cells of heart, endocrine glands) and cancer cells increases. With good body homeostasis the natural hormones are not capable to cause tumour as they stimulate cells of the immunity more than degenerate one, and as a result, it will lead to destruction of cancer cells by immunocytes. The strong stimulatory effect of many hormones on the immune system explains why one million cancer cells released by a small one-gram tumor into the blood flow each day do not form metastases (accumulation of cancer cells in remote tissues) in most people. Natural killer cells destroy every cancer cell in blood. This anti-cancer activity explains why IGF- 1 remains neutral or protects against the respective types of cancer (for example, cervical cancer), while in the laboratory this most valuable compound has extended the life of cancer cells developing in isolation. Other hormones such as melatonin systematically retard the development of cancer cells even in the laboratory!

3. The misunderstanding because of the discovery, which revealed that the mono therapy with estrogen (without progesterone) dramatically increases the risk of endometrial cancer. Endometrium is the inner layer of the uterus.

The risk of endometrial cancer is completely leveled due to compensation of sufficient amount of progesterone for estrogen. Even women after hysterectomy (removal of the uterus) need to take progesterone after estrogen in order to prevent excessive stimulation with estrogen of the mammary glands and the brain. Consequently, there is no reason to prohibit the use of estrogen, since there is a solution: additional introduction of progesterone.

4. Incorrect interpretation of the two studies on the development of cancer after the use of sex hormones, published over 50 years ago, has led many to the suspect that the use of sex hormones can cause or accelerate the development of breast and prostate cancer.

The first publication reported about skin cancer in mice treated with excessive amounts of estrone (estrogen) to treat the outer covers. From the time of this publication many other studies demonstrated that a huge redundancy of estrogen, which is not used in normal medical practice, and a wrong prescription – test animals did not experience shortage of estrone – gave rise to persistent association between the intake of female hormones and related type of cancer.

The second publication reported details of the reactivation of prostate cancer with testosterone therapy in a single man who had been neutered long ago. Many researchers after this article repeatedly argued that its results only show isolated incident and an incorrect prescription of male hormones. In the case of men who have undergone castration long ago (note that only a few men have experienced so extreme androgen deficiency), the introduction of testosterone should be referred with extreme caution. In all other cases, the experts report that testosterone treatment, or one of its derivatives, does not provoke prostate cancer, does not accelerate the development of tumors which existed earlier. On the contrary, some studies state that androgen therapy slows the development of aggressive forms of prostate cancer (with metastases) and prolongs the life of patients in the last stage.

Incorrect interpretation of these out-of-date studies and the lack of analysis of false medical dogmas generated by them, clarify the reasons that have allowed misconceptions about sexual hormones and malignant tumors to take root in the minds of the public and medical professionals.