What is meant by “hormones”?

The term “hormone” comes from ancient Greek (ὁρμᾶν hormān) and means “to drive” or “to excite”. In medical terms, the term was coined by Ernest Starling in 1905:

Hormones are the body's own neurotransmitters, which consists of a endocrine gland in the bloodstream be submitted in order to in other organs a specific effect (A special form are the so-called “neurohormones”, which are produced by nerve cells and released into the blood.)

So there are 3 characteristics of hormones:

• messenger substances that are produced in the hormone glands
• Are transported in the blood to their site of action
• Specifically change the activity of the target cells

What are the functions of hormones?

Hormones regulate a variety of physiological mechanisms and behavioral activities, such as:

• growth and puberty
• metabolism
• body temperature
• sleep / biorhythm
• water balance
• memory
• blood pressure / heart rate / blood lipids
• energy balance (blood sugar)
• sensations / moods / feelings / stress
• Sex / Reproduction / Pregnancy

Each hormone has its own unique biochemical structure and functions according to the “lock-key principle”.

What types of hormones are there?

3 hormone classes:

• amino acid derivatives
  • T3 and T4 from the thyroid, adrenaline and noradrenaline from the adrenal gland, melatonin (“sleep hormone”), serotonin (“feel-good hormone”)
• protein & polypeptide hormones
  • Are broken down in the intestine – therefore no oral administration possible
  • Examples: TSH, ACTH, FSH, LH, insulin from pancreas
• steroid hormones (Steroids are  ring-shaped molecules that belong to the fats and are part of the cell membrane; all are derived from cholesterol)
  • Lipophilic (“fat-soluble”) – are bound to globulins and transported in the blood
  • Examples: estrogens, progesterone, androgens, aldosterone
  • Sites of synthesis of steroid hormones:
    • Cortisol (“stress hormone”): adrenal glands
    • Testosterone (“male hormone”): testes (80%)/ovaries (50%), adrenal glands
    • Estrogens (“female hormones”): testes/ovaries & placenta, adipose tissue, adrenal glands
    • Progesterone (“pregnancy hormone”): testes/ovaries & placenta, brain, adrenal glands
    • DHEA (“Good-Aging Hormone”): testes/ovaries, brain, adrenal glands (90%)

Focus on adrenal hormones

The adrenal gland is the key organ for optimal stress processing.The following hormones are produced by it:

• Aldosterone --> regulation of sodium, potassium and fluid levels
• Cortisol --> regulation of blood sugar, anti-inflammatory, stimulation of the central nervous system, normalization of the stress response
  • Inhibition of HDL cholesterol and increase of LDL cholesterol
  • Anti-inflammatory (inhibition of the transcription factor NFkB)
  • Humoral immune response (Th2 shift), antiallergic
  • Suppresses cellular immune response à reduced infection and tumor defense
  • Cortisol antagonists are progesterone and DHEA
• DHEA  --> Formation of sex hormones, regulation of cortisol levels, "anti-aging"
  • DHEA levels decrease sharply over the course of life: increase until about the age of 20, then halve until about the age of 50 and at the end of life (~80 years) still about 10% of the initial levels
  • DHEA can control negative effects of excessive cortisol secretion
  • “Character profile” DHEA: anabolic and immunizing
    • athero- and cardioprotection
    • Anti-diabetic (increase in insulin sensitivity, glucose utilization and lipolysis)
    • Osteoprotection (reduces osteoclast activity and increases bone density)
    • Increased vitality (mental and somatic)
    • Immunoprotection (modulates towards normalization of Th11-Th2 shift, increase in natural killer cells, anti-inflammatory)
    • Improves muscle-fat ratio
    • Dermaprotection (improves skin thickness, elasticity, oiliness and moisture)
  • Optimal target range DHEAS:
    • Women: 2000-2800 ng/ml
    • Men: 4000-5000 ng/ml
  • Adrenaline, noradrenaline --> reaction to fight or flight situations

Possible symptoms of adrenal insufficiency

• Constant fatigue despite sufficient sleep
• Dizziness after standing up quickly
• Lower tolerance threshold / higher susceptibility to stress
• Increased menstrual pain
• craving for salt or salty foods
• Poor memory ("scattered")
• Lack of energy (lethargy), reduced performance
• depressive phases
• Significantly decreasing libido
• Improvement of well-being especially after dinner

control circuit of thyroid and adrenal hormones

• Thyroid and adrenal glands influence each other
• Via a control circuit, the pituitary hormones TSH and ACTH in the brain activate the thyroid gland to produce thyroxine and the adrenal gland to produce cortisol.
• Put simply, the division of roles is as follows:
  • The thyroid provides energy in the body and regulates it (via T3 and T4)
  • However, the adrenal glands must be strong enough to handle this metabolic energy.
  • This can result in “poorly controlled hypothyroidism,” which shows little progress even with therapy.
• When the adrenal cortex is exhausted, the following “vicious circle” occurs:
  • Pituitary gland also reduces ACTH --> exhausted adrenal gland leads to lower cortisol production
  • TSH is reduced --> subclinical hypothyroidism (adaptation of the body to the cortisone deficiency)
  • Danger: If this hypothyroidism is treated with L-thyroxine, the pituitary gland secretes ACTH, urging the adrenal gland to produce more cortisol.However, if the adrenal gland is already exhausted, then the symptoms of adrenal insufficiency only really become apparent. In the case of hypothyroidism, adrenal insufficiency should always be clarified as a possible actual cause!
• Excursus Hashimoto (Source: Schulte-Uebbing 2012):
  • There is a connection between the occurrence of Hashimoto's thyroiditis and estrogen dominance (pregnancy improves Hashimoto).
  • With additional administration of progesterone to replace thyroid hormones, anti-TPO decreases (30-50% within 2-6 months).
  • Sleep, mood, and physical and mental resilience also often improve with this combination therapy.
  • It is important to simultaneously compensate for a frequently existing zinc, selenium and vitamin D3 deficiency

Focus on estrogen and progesterone

estrogen

• “Character image” estrogen: feminine, soft and moisturizing
• There are 3 different estrogens in the body:
• Estrone (E1) = the storage form
• Estradiol (E2) = the “main estrogen” (the most effective estrogen)
  • "Makes the woman a woman"
  • Stores fat, stores water
  • Slows down metabolism by inhibiting thyroid function
  • Reduces the overall risk of heart disease by 40-50%
  • Improves mood and increases brain memory performance
  • Slows down bone loss by inhibiting osteoclasts
  • Promotes cell development of the uterine lining and breast in the first half of the cycle
• Estriol (E3) = the “mucosa estrogen” (but has only about 10% of the biological activity of E2)
• Ideal ratio E1 : E2 : E3 is 10 : 10 : 80 to 20 : 20 : 60
• Typical estrogen deficiency symptoms:
  • Depressive mood
  • Cosmetic aspects such as crow's feet or vertical mouth wrinkles
  • mucosal atrophy, dystrophic breasts
  • sleep disturbance
  • Slim, petite, perfectionist

progesterone

• Occurs in women and men
• precursor of testosterone
• 20% of the receptors are located in the brain
• “Character profile” progesterone: balancing and energizing
  • Natural antidepressant – the “feel-good hormone”
  • neuroprotective
  • Important role in fat burning
  • Dehydrates (antimineralocorticoid effect)
  • Improves thyroid function
  • Protects against breast pain and cysts
  • Apoptosis promotion especially in the uterus, ovaries, breast and prostate
  • Stimulates bone formation via osteoblasts
  • Normalizes blood sugar levels, lowers insulin levels
• Typical progesterone deficiency symptoms:
  • Headaches and migraines, especially premenstrual
  • myoma formation
  • spotting, hypermenorrhea (up to iron deficiency anemia)
  • difficulty falling asleep
  • aggressiveness, inner restlessness
  • Chronic fatigue
  • Increase in abdominal fat ("pear type")
  • lack of libido

The “hormone triangle” of estradiol/progesterone/testosterone

All hormones interact with each other to form the individual “hormone orchestra”.If one of them is raised or lowered, it will affect all the other “players”.

• For example, the physiological estradiol/testosterone ratio is 1:6 in women and 1:10 in men.
• The physiological estradiol/progesterone ratio is 1:100 – 1:200 across genders.

There are also hundreds of genes whose promoters are controlled by estrogens/progesterone. This affects more gene sections than was previously thought. If estrogens/progesterone are lacking, there are disturbances in gene control. This explains the multitude of possible complaints associated with estrogen/progesterone deficiency. Hormonal supplementation is therefore not about "rejuvenation" but rather about providing the most causal therapy possible.

What can disrupt hormonal balance?

• Age-related à menopause (see below)
• Chronic stress
• sleep disorders
• Hormonal contraception (pill, coil, ring, patch)
• surgery (uterus, ovaries)
• thyroid disease
• pituitary gland disorder
• anorexia / eating disorders
• environmental toxins (plasticizers - especially BPA)
• etc.

The "menopause"

What are typical “menopause” symptoms in women and men?

Woman

• hot flashes
• sweating
• sleep disorders
• listlessness
• Dry mucous membranes, painful sex
• depression
• nervousness
• irritability
• memory impairment
• hair loss
• increase in body fat
• joint pain
• loss of muscle mass
• skin aging / wrinkle formation
• osteoporosis
• bone pain
• joint pain
• heart palpitations
• cardiac arrhythmias

Man

• Decreasing sexual desire
• erectile dysfunction
• depression
• sleep disorders
• irritability
• listlessness
• memory impairment
• states of exhaustion
• increase in body fat
• loss of muscle mass
• high blood pressure
• Elevated cholesterol levels
• skin aging / wrinkle formation
• osteoporosis
• bone pain
• joint pain
• heart palpitations
• cardiac arrhythmias
• sweating

What happens on a hormonal level during the “menopause” (climacteric)?

“Myth of estrogen deficiency” in menopausal symptoms:

The prevailing opinion is that menopausal symptoms result from an estrogen deficiency. Accordingly, treatment is carried out with “estrogens”.

However, estrogen continues to be produced, but in smaller quantities and not in the ovaries, but predominantly in the fat cells from the male hormones androstenedione and testosterone (with the help of the enzyme aromatase).

The problem, however, is that the balance between estrogen and progesterone is no longer correct, as the progesterone level drops much faster than the estrogen level:

During menopause, estrogen levels drop to below 25 ng/l in the first half of the cycle and below 80 ng/l in the second. Progesterone levels are very low, tending towards zero. FSH (follicle-stimulating hormone - produced in the pituitary gland and affects the female menstrual cycle and is responsible for the proper functioning of the reproductive system in women), on the other hand,  rises to values ​​above 12 IU/l.

This means that contrary to popular belief, at the onset of menopause it is not the lack of estrogen, but the progesterone, which drops even more sharply in relation to estrogen, that is responsible for the hormonal imbalance between estrogen and progesterone! It is not absolute values ​​but ratios that determine well-being. The physiological progesterone/estrogen ratio in women is 1:100 to 1:200. At the onset of menopause, this ratio deteriorates significantly to the detriment of progesterone.

1. phase of the menopause: loss of progesterone

• Irregular cycle from the age of 45
• weight gain
• water retention
  à Therapy: Progesterone – no estrogen/progesterone

2. phase of the menopause: loss of estrogen

• hot flashes
• sleep disorders
• joint pain
• Dryness all over the body (genitals, eyes)
• muscle pain
• hypercholesterolemia
• labile blood pressure
• Irregular heartbeat / palpitations

3. phase of the menopause: loss of androgens

• Stimulate the metabolism
• Strengthen the connective tissue
• Important for the psyche
• Important for libido
• starting material for the synthesis of other hormones
• weight problems in the abdominal area
• Enlarging breasts
• Chronic fatigue

Important: Male hormones are also important for women! And female hormones are also important for men!

deficiency-associated complaints

• progesterone
  • Depressive mood
  • restlessness, irritability
  • anxiety
  • Irregular / shortened cycles
  • bleeding disorders, hyperplasia
  • mastodynia, mastopathy
  • edema, labile hypertension
  • osteopenia
• estrogen
  • sweating
  • mood lability
  • sleep disorders
  • Vaginal dryness
  • Prolonged menstruation
  • joint pain
  • incontinence
  • osteopenia
• Androgens (especiallyTestosterone)
  • libido reduction
  • loss of vitality
  • Chronic fatigue
  • Low-fat skin
  • anemia
  • atrophy (tissue, muscle)
  • fat accumulation

therapy of or during menopause

• Symptomatic
  • antirheumatics
  • blood pressure medication
  • antidepressants
  • bisphosphonates
  • sleeping pills
  • painkillers
  • Synthetic hormones
• Holistic
  • natural identical hormones
  • nutritional supplements

What are hormones made of?

• Synthetic hormones
  • urine of pregnant mares
  • Chemical
• Bioidentical hormones
  • : Progesterone from the yam root (Dioscorea vilosa)
  • Identical to the body's own hormones
  • Same spectrum of effects
  • No increased cancer risk

Effects of synthetic hormones

• Foreign substances for the body (different chemical structure)
• Cancer risk increased by up to 80% (see below)
• Ultimately unknown effect
• Biological structures change
• Relieve only a few symptoms
• Promote remodeling processes in the body

How Synthetic Hormones Can Cause Breast Cancer

“Vienna. Scientists at the Institute of Molecular Biotechnology (IMBA) of the Austrian Academy of Sciences clarified the connection between the intake of synthetic sex hormones and increased risk of breast cancer. (…) Only a small proportion of those affected have inherited the predisposition; the tumor is usually acquired through external influences. (…) Factors that promote breast cancer include the intake of synthetic progesterones (gestagens) as part of hormone replacement therapy or for hormonal contraception. (…) Original article: Osteoclast differentiation factor RANKL controls development of progestin-driven mammary cancer (Schramek et al.). Nature AOP, September 29, 2010, doi:10.1038/nature09387; Source: RANK Ligand mediates progestin-induced mammary epithelial proliferation and carcinogenesis
(Gonzalez-Suarez et al.). Nature AOP, September 29, 2010, doi:10.1038/nature09495

Risks of Synthetic Hormones

Source: Breast cancer data according to Fournier et al. 2005 and Clavel-Chapelon et al. 2005/2006 in 69647 women (in Europe): No increased cancer risk is evident under natural estrogen and progesterone.

Difference between bioidentical hormones and synthetic hormones (= medications with hormonal effects) – using progesterone as an example:

• In the 1930s, progesterone was first extracted from pig ovaries and then from the placenta of women.
• In 1939, progesterone was produced from the diosgenin of the yam root (Incidentally, this discovery also led to the development of the birth control pill in the USA in 1951), which reduced the price of progesterone from over 100 USD/gram to a few cents.
• But that was natural Progesterone has become uninteresting for the pharmaceutical industry, as natural substances cannot be patented. This led to the development of "gestagens" - ie drugs with hormonal effects.
• The difference between hormones and drugs with hormonal effects is the altered biochemical structure:
  • Bioidentical hormones have an identical structure to the body’s own hormones, i.e. they trigger original metabolic processes and integrate into the natural synthesis pathway.
  • Synthetically modified hormones, on the other hand, are foreign bodies!
• No natural hormone causes side effects in the dose that the body is used to.

Hormones in comparison:

Which micronutrients are useful for menopausal symptoms?

• Yam root as a source of diosgenin. Diosgenin is very similar to progesterone (corpus luteum hormone) naturally produced by the ovaries.
• red clover and hops
  • Belong to the phytoestrogens (3 groups: isoflavones (e.g. soy, hops, red clover), lignans (e.g. linseed) and coumestans (e.g. black beans or alfalfa sprouts)
  • Blocking of proliferative ER-alpha receptors: breast, uterus, liver
  • Estrogen-like effect via apoptotic ER-beta receptors: bones, vessels, brain, bladder
  • Antioxidant effect and strengthening of the immune system
• Monk's pepper:
• Strengthens the progesterone side / has a diuretic effect
• Lowers prolactin and increases progesterone levels in the second half of the cycle
• Main symptoms: Mastodynia, premenopausal cycle and bleeding disorders, premenstrual depressive mood, premenstrual edema
• Cordyceps: In TCM, Cordyceps is used for menopausal symptoms because it strengthens the kidney energy. This is said to relieve both hot flashes and cold symptoms.
• Valerian: a study with 60 postmenopausal women has examined the influence of valerian on unpleasant sweating  studied – with the result that valerian reduces hot flashes  compared to placebo (cf. https://www.tandfonline.com/doi/abs/10.1080/03630242.2017.1296058)
• Iron: Men and women after menopause lose about one milligram of iron every day. Since women often have long and heavy periods, especially at the beginning of menopause, iron deficiency is not uncommon.
• Vitamins B6, B9 (folic acid) and B12: In combination with vitamin B12 and folic acid, vitamin B6 is essential for breaking down the cell toxin homocysteine. This occurs in greater proportions in the blood due to the reduced estrogen levels during menopause. Vitamin B6 and B12  also support the production of the “feel-good hormone” serotonin.
• Melatonin: increases the body's estrogen sensitivity