Our approach to mental health and wellness incorporates both preventive and nutritional approaches with particular attention to biochemical imbalances.

Integrative Medical Institute

Bio-Identical Hormone Treatment

IMI Philosophy

We here at IMI work at finding just the right balance of hormones for you. We recognize that everyone is uniquely different. We will obtain baseline levels and proceed accordingly. Everyone responds differently at different levels, but there is an optimal level for you. Our commitment is to work with you to find that optimal level. We work closely with numerous compounding pharmacies and there are a multitude of different delivery systems. After meeting with you we will determine the best system for you.

Bio-identical hormones have a molecular structure that is identical to hormones that are naturally produced by the human body, and are intended to replace these hormones when their levels decline due to aging, disease, stress, medications, or surgery. Hormones conduct the language of cells. Our bodies have over 60 trillion cells with each needing to communicate with one another.

Hormones are the chemical messengers that travel through our blood stream, enter cells by unlocking a door called a receptor, and flip the switches that govern growth, development, and mental and physical functioning. The exact chemical structure of the body’s hormones is incredibly important, because in order for hormone therapy to fully replicate the normal functioning present in the human body it must match the original structure of that hormone exactly

What Are Bio-identical Hormones?

Bio-Identical hormones have the same chemical structure as the hormones made by the human body. Structural differences exist between bio-identical hormones and those available commercially, which are typically synthetic (i.e. esterified estrogens, medroxyprogesterone) or animal derived (i.e. conjugated equine estrogens). In order to be patented, synthetic hormones have side chains added to a natural substance. Synthetic hormones are not found in humans, and are not identical in structure or function to the bio-identical hormones they are intended to replace.
Our hormones play a major role in how fast we age. The action of the various hormones is very complex. In part they act to advance the life cycle according to the biological plan. Alternatively, they may go haywire, promoting disease states associated with the aging process.

Since hormones influence the rate at which we age, considerable research is underway to evaluate the feasibility of “replacement therapy” to forestall the aging process and the degenerative changes that accompany it. “Replacement therapy” has been around for some time in the treatment of menopause. Many gynecologists advocate the use of “estrogen” and “progesterone” in the alleviation of menopausal symptoms. But “replacement therapy” and the use of hormones should not stop there. The use of testosterone, the adrenal hormones such as DHEA, pregnenolone, melatonin and Human Growth Hormone are now just being investigated. The sex hormones, such as estrogen, progesterone and testosterone, which are deliberately programmed for decline, are obvious targets for intervention. In women, menopause is distinct. In men, what is becoming known as “andropause” is less clearly demarcated, perhaps masking the importance of testosterone. The adrenal androgens too, best exemplified by DHEA, may pace aging in both of the sexes through a change of life dubbed “adrenopause” by hormone researchers.

Let us take a look at these various hormones, and contrast some of them with their synthetic counterparts.

Estrogen and Progesterone

When we talk of hormones and women, most of us think of estrogen and a few more will also include progesterone. Estrogen and progesterone are closely interrelated in many ways. In a normal functioning premenopausal woman, estrogen is made from progesterone and/or androgens within the cells of the body. After menopause, estrogens are converted from adrenal produced androgens (DHEA), primarily in body fat. Estrogen and progesterone are, in many ways, antagonistic; yet each sensitizes receptors for the other. A key to hormone balance is the knowledge that when estrogen becomes the dominant hormone and progesterone is deficient, the estrogen becomes toxic to the body; thus progesterone has a balancing or mitigating effect on estrogen.

Estrogen is responsible for the maturation of young women at puberty. Estrogen causes the accumulation of fat that gives the female body its contours, but in excess or when it is not in balance with progesterone, can contribute to excess fat accumulation. When women consume considerably more calories than what is needed, estrogen production increases to supernormal levels and may set the stage for estrogen dominance syndrome and exaggerated estrogen decline at menopause.

In the United States and most industrially advanced countries, diets are rich in animal fats, refined starches and processed foods. This provides calories in excess to the bodies needs and leads to estrogen levels in women twice as high as those do in women of the more agrarian third-world countries.

What is Estrogen Dominance?

When your body is in the company of excess estrogen while at the time in the absence of adequate levels of progesterone, this is known as estrogen dominance.

What causes estrogen dominance?

Dominance of estrogen can start early on in a women’s menstrual cycle. Young women that first enter menarche may suffer tremendously with difficult periods. Many of these young women are started on birth control pills to help regulate the frequency and severity of their periods. Some women will develop estrogen dominance syndrome much later in life, sometimes as a result of poor diet, liver impairment or environmental factors. Also, estrogen dominance may be a result of anovulatory cycles before menopause, Anovulatory cycles are menstrual cycles in which no ovulation has occurred. A special gland called the corpus luteum forms on the surface of the ovary at the site of ovulation. This gland produces progesterone that remains for the last half of the menstrual cycle. Without ovulation, less progesterone is produced, which can cause estrogen imbalance in some women.

Estrogen Dominance Syndrome

In this context, it is worthwhile to compare the physiological effects of estrogen versus progesterone:

Estrogen’s effects

  • Stimulates breast tissues
  • Increases body fat
  • Causes salt and water retention
  • Depression and headaches
  • Interferes with thyroid hormone
  • Increases blood clotting
  • Decreases sex drive
  • Impairs blood sugar control
  • Causes loss of zinc and retention of copper
  • Reduces oxygen levels in all cells
  • Reduces vascular tone
  • Slightly restrains osteoblast function
  • Reduces vascular tone
  • Increases the risk of autoimmune disorders
  • Increases the risk of endometrial & breast cancer

Progesterone’s effects

  • Protects against fibrocystic breasts
  • Helps use fat for energy
  • Natural diuretic
  • Natural antidepressant
  • Facilitates thyroid hormone action
  • Normalizes blood clotting
  • Restores sex drive
  • Normalizes blood sugar levels
  • Normalizes zinc and copper levels
  • Restores proper cell oxygen levels
  • Restores normal vascular tone
  • Stimulates osteoblast bone building
  • Restores normal vascular tone
  • Precursor of corticosteroid disorders
  • Prevents endometrial and breast cancer

It is clear that excess estrogen, when unopposed or unbalanced by progesterone, is not something wholly to be desired. It becomes clear that many of estrogen’s undesirable side effects are effectively prevented by progesterone. I would propose that a new syndrome be recognized: That of estrogen dominance. This syndrome, with symptoms familiar to most women, commonly occurs in the following situations:

  1. Estrogen replacement therapy.
  2. Premenopause (early follicle depletion resulting in a lack of ovulation and thus a lack of progesterone well before the onset on menopause).
  3. Exposure to xenoestrogens (foreign chemicals that have an estrogen effect in the body that cause early follicle depletion).
  4. Birth control pills (with excessive estrogen component).
  5. Hysterectomy (can induce subsequent ovary dysfunction or atrophy).
  6. Postmenopausal (especially in overweight women).
  7. Estrogen use in the meat industry.

Some other causes of estrogen dominance include:

Stress

Stress causes adrenal gland fatigue and reduces progesterone output. Excess estrogen in turn causes insomnia and anxiety, which further compounds the taxing of the adrenal gland. This cycle leads to a further reduction in progesterone output.

Liver Disease

Liver disease from drinking too much alcohol, taking drugs that impact the liver or even certain viral syndrome reduces the breakdown of estrogen, leading to higher levels of estrogen.

Deficiency of Vitamin B6 and Magnesium

Too much estrogen also tends to create a deficiency of zinc, magnesium and the B vitamins These all play an important role in hormone balance

Testosterone

Most notably, bio-identical testosterone therapy helps improve mood, attitude, cognitive ability, and general outlook on life.
Bio-identical testosterone improves muscle mass and strength, rebuilds bone, strengthens the heart and blood vessels, lowers total cholesterol and blood sugar, raises HDL (“good”) cholesterol, lowers blood pressure, lessens the chances of blood clots, improves tissue oxygenation, improves the health of a non-cancerous prostate gland-and that’s all before we get to testosterone’s positive effects on libido and your sex life.

How safe is testosterone?

Bio-identical testosterone has the same molecules present in human bodies forever not some patentable pseudo-testosterone.

The Institute of Medicine committee discouraged testosterone therapy by stating, “There is still much we don’t know about whether testosterone therapy might increase the risk of prostate cancer,” said committee chair Dan Blazer, professor of psychiatry and behavioral sciences, Duke University Medical Center, Durham, N.C.. The report stated that: “The committee found no compelling evidence of major adverse side effects resulting from testosterone therapy, but the evidence is inadequate to document safety.” However there are actually dozens of studies showing just how safe testosterone therapy really is.

In 2002 the International Journal of Andrology published a study that examined 207 men, ages 40 to 83, who had all been found to have low or low-normal testosterone levels. The researchers looked at multiple parameters, including prostate volume; PSA; lower urinary tract symptoms, like frequency, urgency, “dribbling,” etc.; and measured levels of several other hormones, including di-hydrotestosterone, or DHT, estradiol, and LH, a marker hormone that has an inverse relationship with testosterone levels-the more LH, the less testosterone and vice versa.

Of the 207 men studied, 187 responded favorably to testosterone treatment. These 187 all showed declines in LH production, as well as improvement in every other parameter measured: Their prostate glands all decreased in size, their PSA numbers went lower, and frequency, urgency, dribbling, and getting up at night all improved.

This study suggested that, far from causing prostate trouble, testosterone is actually beneficial for the prostate gland in the vast majority of cases.

The more testosterone, the sharper your brain…

Researchers also continue to demonstrate that testosterone is beneficial for male mental function. Some of the recent studies support this conclusion :

  • “short-term testosterone administration enhances cognitive function in healthy older men”
  • “decreased serum testosterone levels….adversely affect verbal memory in normal young men. These results suggest that short-term changes in sex steroid levels have effects on cognitive function in   healthy young men”
  • “beneficial changes in cognition can occur in…men using testosterone replacement and di-hydrotestosterone [DHT] treatment…”
  • “Positive associations between testosterone levels and cognition are consistent with an effect of androgen treatment…”

Heart-Health Benefits.

In the 40s, testosterone was found to be an effective treatment in 91 of 100 cases of angina. Then in the 70s, research showed it to be effective in improving abnormal electrocardiograms. And in the 90s, a Chinese study showed improvement in both angina and electrocardiograms in older men using testosterone.

Research continues to confirm that testosterone is healthy for men’s hearts. Two examples taken from very recent studies:

  • • “Men with proven coronary heart disease had significantly lower levels of total testosterone, free testosterone, free androgen index and estradiol…For the first time in clinical settings it has been demonstrated that low levels of free-testosterone was characteristic for patients with low ejection fraction.”

Ejection fraction measures the amount of blood pumped from one of the heart’s chambers, so low testosterone is associated with less blood being pumped.

  • “Testosterone reduced QT dispersion in [men with] heart failure.”
  •  Higher QT dispersion, a measurement taken form an electrocardiogram, indicates higher risk of death from cardiac arrhythmia. That means in the above study, testosterone reduced the risk of death from cardiac arrhythmia.

Bone Building

By the time most men hit 70, they “catch up” with women and have just as much osteoporosis and as many bone fractures as women do.

Testosterone supplementation

If your testosterone levels are low and you decide to take testosterone-real, bio-identical testosterone, we will make sure to have your PSA level checked before you start, and then check it again in two to three months. If it rises more than a little in that time, we may have uncovered pre-existing prostate cancer. We would stop your therapy right away, until you’ve fully investigated the situation.
Testosterone doesn’t cause prostate cancer all by itself. But it can significantly increase the growth rate of a pre-existing cancer that may not have been detected yet.

Keeping all your hormone levels right

Some of your testosterone actually gets converted into estrogen. This small amount of estrogen has important functions for men, just as small quantities of testosterone have important functions for women. But in some older men, testosterone-to-estrogen conversion is dramatically accelerated, resulting in levels of estrogens much higher than usual for men.