Bio-identical, synthetic and plant hormones: what's right for you? Sort through the hormone hullabaloo with Bill Cheek, RPh.

Hormones. The mere mention of this word evokes different thoughts from different people. For some, it might mean relief of tormenting hot flashes. For others it might conjure tip dreams of the fountain of youth and an increase in libido. To athletes, it might mean strength, endurance and power: an edge. And, others might think of hormones as a dangerous drug that could have something to do with cancer, stroke and heart attacks. Let's clear tip some misconceptions about hormones so that you may be better able to make the right decision for you about hormone therapy.

What is a hormone? According to the Medical Dictionary, a hormone is a substance produced within the body of an animal and carried by the blood to an organ that it stimulates. In other words, a hormone is like a messenger produced in one part of our body that goes to another part of our body and delivers a message. In this article, I will refer to our sex hormones, the ones that give us our male and female characteristics. For men, it is testosterone; for women, I will talk about estrogen, progesterone and testosterone.

For all practical purposes, there are three different types of treatment options for hormone balancing: natural, or bio-identical hormones; synthetic hormones; and phyto, or plant hormones. There is much confusion about the differences in these, so don't feel alone if you have been bewildered by all of the information. If it makes you feel any better, many health care practitioners don't know the difference either!

First, let's talk about bio-identical hormones, meaning those that are identical in chemical structure to human hormones. They are derived from the molecule diosgenin, which occurs naturally in soybeans and the wild yam. Diosgenin is isolated from these plants and is converted in the lab to all of the human hormones: estradiol, estriol, estrone, progesterone, testosterone, DHEA, and pregnenolone. When taken up into our bloodstreams, these hormones are very physiologically active substances and have a powerful effect on humans. Some of these require a prescription from a medical doctor and some do not.

Second, synthetic hormones are, generally speaking, a version of human hormones with a twist. The molecules are manipulated and changed to make them more powerful, longer acting, and, in the process, patentable. Any substance that occurs in nature is not patentable in the U.S., so with a variation of a molecule, a pharmaceutical company can produce an exclusive product that is protected from competition lot 17 years. These all require a prescription from a physician.

Third, many herbs contain constituents that may have some hormone balancing properties by weakly binding to receptor sites without actually altering blood hormone levels. In other words, plants do not contain human hormones, nor can our bodies convert these substances over to a hormone Herbs like black cohosh, red clover and chasteberry tree. and foods like soy and yam have shown to be very beneficial to women during years of hormone fluctuation. These are all available over the counter without a prescription.

It is possible that the first sex hormone hit the market around 1900: the androgen (male) hormone testosterone, extracted from bull testicles. It was expensive, crude and flail of impurities. Drug companies began to synthesize female hormones in the 1940's and 50's, starting with very powerful and dangerous estrogens such its diethylstilbesterol (DES), and over time have produced more effective, safer and lower potency estrogens and progestins, mainly for use in birth control. The most well known hormone is Premarin[R], which is actually not synthetic, but rather is derived from the concentrated urine of a pregnant mare, thus its name. These non-human hormones are very effective in relieving uncomfortable symptoms of hormone change, but side effects are fairly common, often limiting their use.

Bio-identical hormones have made quite a dash to the forefront of today's hormone therapy, for men and women alike. Several reasons account for this: baby boomers tend to seek out more natural treatments than their parents, they are more widely available today through compounding pharmacies, and synthetic hormones have the unpleasant possibility of causing serious problems like stroke, blood clots and even an increase in the risk for cancer, whereas natural hormones, while not having the luxury of a well-done long-term study of effectiveness versus risk, seem to be gentler on the human body. Interestingly, several bio-identical hormones are produced by drug companies--Estrace[R] (estradiol), Prometrium[R] (progesterone), and Androderm[R] and Androgel[R] (testosterone)--so there is growing evidence of safety and efficacy with these hormones.

There is no doubt that when men and women go through andropause and menopause, the aging process speeds up rapidly. There is a wide range of opinions on what to do, if anything, about this. Several viable options are widely available in our country. First, you can simply let nature run its course as it has done for eons, living a healthy lifestyle through common sense and wisdom of our bodies. This would include using naturally occurring herbs and foods. A second option is the use of synthetic hormones, or thirdly, we can replace our hormones with those that look like ours: bio-identical hormones.

Other than alleviating menopause symptoms or as birth control, why would a person even consider hormones, you may ask? Some reasons might be on this list: libido; tissue integrity, including skin or vaginal; bone density, muscle maintenance, energy, motivation, hair, longevity and anti-aging. Also, there is a growing body of evidence, maybe hopeful thinking and maybe reality, which states that maintaining reasonable hormone levels in men and women can slow down more serious degenerative diseases like cardiovascular disease, arthritis, osteoporosis and even cancer. But for now, the best we can do is look at our options and Examine our hearts to see what we want to do, making the decision based on the best information we have to date.

As always, good health for the long run depends on good food, plenty of water and rest, balance between work and play, friends and family, a positive attitude and a healthy spirit. Be well!

Bill Cheek, RPh, is the co-owner of Nature's Pharmacy and Compounding Center at 752 Biltmore Avenue in Asheville, North Carolina. He can be reached by calling the pharmacy at 828-251-0094 or through their website at www.naturespharmacy.biz.