By William Kay, M.D
Many of the effects that hormones have on the body have been elucidated, but hundreds of new effects (good and bad) are being discovered all the time. The hormones that our bodies make are tightly controlled by a myriad of complex feedback loops, metabolism, elimination, carrier proteins, etc. The bottom line is that such complexity should instill tremendous respect in any person deciding to take hormones and any clinician deciding to suggest their usage. Since the results of the Women’s Health Initiative was published and clearly demonstrated the risks of over dosing menopausal women on pharmaceutical hormones, there has been an increased marketing push to find a substitute. The buzz word for the substitute is “bio-identical” hormones.
Bio-identical hormones are synthesized from natural starting material like the Mexican yam and soybeans. The starting compounds in these plants are sterols called diosgenin and stigmasterol. That is where the “natural” part ends. These compounds are then run through chemical reactions in a lab to synthesize hormones such as progesterone, estrogens, and testosterone. What is vital to understand is that the final products of these synthetic processes are hormones that are not chemically identical to the hormones our bodies make. These synthesized hormones that are being marketed as bio-identical have different ratios of carbon-13/carbon-12 than human hormones and they also have a mixture of stereoisomers whose activity within our body is difficult to predict.
Taking hormones should only be considered when a clear deficiency has been discovered that is not correctable by less invasive measures. Are there reasons to consider hormonal therapy? Yes. Are “bio-identical” hormones without risk? No. Many of our hormone imbalances are a result of stress, poor diet, physical inactivity, environmental toxins, and etcetera. If you are seeing a clinician that jumps at fixing your hormones by starting with hormone therapy, you should be suspicious. If they tell you its safe — they are “bio-identical”, then you will know that they have been fooled by the new marketing ploys and have not done their research.