Hormones are natural substance produced in our body. They are made of amino acids, amines, or even steroids. They maintain an efficient body system through regulating target organ function. Hormones are involved in various body system regulation, such as: immunity, energy, sleep, emotion, menstruation, sexual function, detoxification, regeneration etc.
Our hormone levels deplete as age increasing. Hormone levels peak at around age 20, and start to deplete as early as age of 25-year-old.
The process of hormones depletion accelerates in response to certain external factors, such as nutritional deficiency, environmental pollution, emotional stress, and poor lifestyle.
While hormone levels deplete, body function becomes dysregulated. Depending on the types of hormone depletion, we could have adverse health effect, such as menstruation abnormalities, high blood sugar, weight gain, abnormal sexual function, low energy, sleep disturbance, and emotional disturbance. Immune system dysregulation causes low immunity, poor recovery, autoimmune disease, or possibly cancer.
Hormone balancing therapy restores the depleting hormones and hence optimize our body function. It also prevents us from developing incurable disease such as osteoporosis, diabetes, depression, anxiety, and cancers.
Traditionally, hormone balancing therapy are achieved with replacement with conventional synthetic hormones (eg: Premarin, PremPro, Progestin etc). These hormones are manufactured in the way that the chemical structure is slightly different from human natural hormones.
Treatment using these hormones could partially restores the depleting hormones, relieving us from menopausal symptoms such as hot flushes and heat intolerance. In addition, it prevents us from developing osteoporosis. However, conventional synthetic hormones are chemically different from human natural hormones, they do not exert the full effects of a naturally hormone. Therefore, the treatment is often below optimal, and long-term treatment is often flawed with side effects.
Studies have shown that long-term use of conventional synthetic hormones could increase risk of getting breast cancer, stroke, dementia, and coronary heart disease.
Bio-identical hormones are produced in the way that the chemical structure is identical to the human natural hormones. Common bio-identical hormones that are being used include 17β-estradiol (E2), Estriol (E3), progesterone (P4), testosterone, and DHEA. As bio-identical hormones are chemically identical to human natural hormones, they produce the same effects as of human natural hormones.
Studies have shown that bio-identical hormones could exert better balancing effects than conventional synthetic hormones. They improve sleep quality, which conventional synthetic hormones do not share the same benefit. While long-term use of conventional synthetic hormones is associated with increased risk of dementia and stroke, studies have shown that bio-identical hormones improve brain function, memory, prevent dementia and stroke. Bio-identical hormones also promote good cholesterol (HDL) production, and improve blood sugar control.
Bio-identical hormones replace and balance our hormones level with much lesser side effects comparing with conventional synthetic hormones. Bio-identical hormones have anti-proliferative effects on breast, protecting breast from developing breast cancer. In addition, bio-identical hormones reduce blood pressure, risk of blood clotting, and coronary heart disease.
Our hormones system is complicated and inter-related. A proper assessment and consultation by trained doctor are required.
Doctor consultation helps you to set a treatment goal, and gives you a better idea of the treatment plan.
The bio-identical hormones have undergone strict and stringent guideline under the requirement of Ministry of Health Pharmaceutical Services to ensure its quality and safety. As bio-identical hormones are chemically identical to the natural hormones, they are as safe as the hormones that naturally present in our body, if used properly.
Appropriate use of bio-identical hormones is crucial. They should only be used for people with clear indication. It should be prescribed after assessed by qualified medical doctor. Regular monitoring is required to avoid under-dosing or over-dosing, and to monitor health improvement. If you think you are experiencing adverse reaction, please stop the hormone products immediately, and consult qualified medical doctor.
Possible side effects of Bio-identical hormones.
The side effects of bio-identical hormones are uncommon if it’s used appropriately. The side effects are mostly due to overdosing. For example, thyroid hormone overdose could lead to nervousness, heat, and palpitation. Occasionally, the side effects could be due to hormones interaction. For example, DHEA replacement could lower cortisol, leading to low blood pressure and fatigue. DHEA replacement might increase androgens, causing oily hair and acne. Most of the side effects can be solved by monitoring, dose adjustment, nutrition, proper instruction of taking the hormone, and lifestyle modification.
The following are some of the side effects experienced by some bio-identical hormones user.
Melatonin induces sleep at night. It increases growth hormone and thyroid hormone, and reduces cortisol. People with melatonin overdose commonly have deep sleep, and occasionally vivid dream. The patient may also experience side effect of waking up early in the morning.
Growth hormone is a major hormone that is responsible for body growth in children. In adult, it maintains organs and their function. Growth hormone overdose increases organ size, such as limbs swelling and excessive muscle growth. Excessive growth hormone excessively stimulates estrogen, thyroid, androgens, and lowers cortisol as well as insulin.
The main roles of thyroid hormone are to maintain metabolism, energy production, alertness and various organ function. Thyroid overdose causes nervousness, anxiety, tiredness, weight loss, palpitation, and tremors. It could lower cortisol, giving symptoms of cortisol deficiency.
Cortisol is a stress hormone, helping us to adapt and cope with the stress. It maintains blood pressure, blood sugar, and regulate inflammation. Excessive cortisol causes swollen limbs, high blood pressure, weight gain, sleep disturbance, skin thinning, and gastric pain.
DHEA expresses its action mainly through conversion into other hormones, such as testosterone and estrogens. It enhances immune system thought one of its metabolites. DHEA overdose can cause high androgens and estrogens, giving symptoms such as oily skin and oily hair. DHEA could lower cortisol, giving symptoms such as low blood pressure, dizziness, and tiredness.
It is essential to maintain a balance between estrogen and progesterone. These hormones are regulating and complementing each other to keep the body in a balance state. These hormones maintain woman body shape and fertility. Estrogen overdose gives symptoms such as anxious, painful breasts, bloating, legs swelling. While progesterone overdose gives symptoms low mood, tiredness, and sleepiness.
This hormone is often called men hormone; however, it is also found in women at lower concentration. Its main role in men is to maintain sexual health. In both men and women, it prevents cardiovascular diseases such as heart attack, diabetes, overweight. In addition, it maintains bone strength and mood in both men and women. Testosterone overdose leads to excessive body hairs, aggression, excessive sexual drive, and acne. In some cases, testosterone is excessively converted to other hormones, such as dihydrotestonsterone (DHT) and estrogen, giving symptoms of such hormone excess.
Other potential side effects include heartburn, loose stool, sleepiness, or allergic reaction.
Bio-identical hormones is prescribed based on your health needs.
Choose hormone test
There are different types of hormone test that suit different health needs. If you are unclear about which hormone test is suitable for you, you may book for doctor consultation.
Fill in questionnaire
In the questionnaire, you will fill in information about your symptoms, medical history, and other relevant information. it’s to understand your current health condition.
Go for hormone test
It is a blood test. You will receive a laboratory request form and information of a designated laboratory via email. Appointment for blood test will be arranged.
Review hormone test result
Result will be sent to you and our doctor via email. Our doctor will arrange an appointment to review the result with you through online. A treatment plan will be discussed with you based on your personal need and expectation.
Receive Bio-identical hormone
Bio-identical hormone will be sent to you after you confirm the treatment plan. Usually a 3-month supply will be sent to you. If no treatment is required, next appointment will be arranged for follow up and review..
Arrange next appointment
After commencement of treatment, an appointment will be arranged for follow up. On next appointment, a repeat test of selected hormones may be required to monitor your health improvement.
People with hormones deficiency often suffers from mild to moderate symptoms. These symptoms may not be life-threatening at the beginning; however, leaving it unchecked, serious incurable diseases may develop, such as diabetes, osteoporosis, depression, uterine fibroid etc.
These symptoms could also affect our work performance and quality of life. Some symptoms, such as emotional symptoms and sleep symptoms could be devastating to one life.
People who is suffering from symptoms of hormones deficiency may require bio-identical hormone replacement.
Menstrual irregularity is one of the commonest presentations of hormone deficiency. It is usually caused by imbalance of the estrogen and progesterone. Beside those, other hormones such as thyroid hormone may be involved. In some cases, these hormones imbalance is associated with ovarian cyst, uterine fibroid, or endometriosis.
There are numerous hormones help to maintain our state of mind and emotion. Those includes thyroid hormones, estrogen, progesterone, testosterone, etc. Deficiency of these hormones could lead to emotional symptoms such as anxious, low mood, irritable, exhausted, and slowness.
Melatonin is one of the most important hormones involved in sleep. Other involved hormones include thyroid hormone, estrogen, progesterone and testosterone. People with sleep hormones deficiency could have difficult to fall sleep. Some of them, even if could initiate sleep, would wake up a few times from sleep during middle of the night. Imbalance or inappropriate fluctuation of sleep hormones could make people sleepiness during day time.
Poor energy is one of the earliest symptoms reflecting hormones deficiency. The symptoms include tiredness upon waking up, after-lunch sleepiness, generalized tiredness, and poor concentration during day time. Most people think exercise improves energy. However, many do not know, without balancing the hormone at first place, exercise in fact makes the symptoms worse. Energy hormones deficiency is usually caused by increasing age, nutritional deficiency, stress, inadequate rest, and over exhaustion. The hormones involved are cortisol, DHEA, testosterone, estrogen, and thyroid hormone.
Metabolic symptoms & weight gain
Metabolic symptoms such as weight gain, high blood sugar, increased visceral fat are associated with increasing age. Hormones deficiency plays an important role in developing metabolic symptoms. As age increasing, hormone levels decrease, losing the ability to maintain body function well. These symptoms are strongly associated with deficient estrogens, progesterone, testosterone, thyroid hormones, DHEA, Insulin-like Growth Factor 1, etc.
Metabolic symptoms are highly associated with cardiovascular diseases such as heart attack, atherosclerosis (blockage of artery), stroke, dementia, diabetes etc.
Allergy related diseases are one of the commonest reason people seeks for doctor consultation. Conventional medical treatment alleviates the symptoms very fast, however, recurrent allergy attack is very common. It is because of underlying immune hormones imbalance. The hormones commonly involved in immune system are cortisol, DHEA, and Melatonin. People with low immune hormones often suffers from prolonged or frequent flu, allergy, eczema, asthma, autoimmune diseases, and poor health.
Different bio-identical hormones have different absorption rate and metabolism. They should be taken following the instruction to maximise their absorption and efficacy.
Some bio-identical hormones are to be taken on empty stomach (T3), while some are to be taken after meal (DHEA, Hydrocortisone). Some are to be taken in the morning (Thyroid, DHEA, Hydrocortisone), while some are to be taken at the evening (Progesterone, Melatonin).
Please follow the instruction on the label of the hormone products. The following are a few instructions.
Apply the cream on upper inner arm evenly
The upper inner arm is thinner and less hairy for better absorption. It’s better to apply the hormone cream over both inner arms, and rub it until the cream distribute evenly over the skin surface. Other optional site includes inner thighs, chest (less hairy), or abdomen.
After application, the hormone can be transferred directly to other people through skin-to-skin contact. Therefore, it is important to avoid direct skin contactwith other people, especially children after application for 2 hours. The hormone will be fully absorbed within 2 hours after application. Upper inner arm is less likely to have skin-to-skin contact with other people, which makes this site the preferred cream application.
Wash your hands with soap thoroughly after applying the cream, to prevent skin-to-skin transfer.
Take the pill/capsule with empty stomach
Take the pill or capsule at least 15 minutes before any meal or snacks with plain water. It is to avoid hormone interaction with other substance, such as: food and other supplements. Some substances bind to the hormones, rendering it unable to be absorbed by our digestive system. In some cases, it directly inactivates the hormones. Thyroid hormone is usually taken with empty stomach.
Take the pill/capsule after meal
Take the pill or capsule within 1 – 2 hours after taking a meal. Taking certain hormone products with meal can increase the absorption. After meal, our digestive system produces digestive enzymes to breakdown the food, and facilitate absorption. Some hormones are best absorbed with food.
Occasionally, some hormone products might cause gastric upset in certain people, who is known to have gastric problem. Taking the hormone products after meal could reduce the side effects. Cortisol and progesterone is usually taken after meal.
Take the pill/capsule with or without meal
Some hormones absorption is not affected by meal, and they are not causing gastric upset if taken with empty stomach. They can be taken with or without meal, depending on people own preference and convenience. Estrogen and DHEA can be taken with or without meal.
Take the pill/capsule in the morning
Our hormone system is dynamic. The hormones fluctuate throughout the day. Some hormones are higher in the morning lower in the evening. Hormones are usually prescribed according to the natural course of the hormones during the day. Thyroid, DHEA, and cortisol are usually taken in the morning.
Take the pill/capsule before sleep / Take in the evening
Some hormones may cause sleepiness, examples are progesterone and melatonin. These hormones are usually taken at night to improve sleep and calm the mind. Some people may absorb the hormone slower, and experience some sleepiness in the morning. Doctor may advise to take the hormone in the evening instead of taking it right before sleep. Melatonin and progesterone are usually taken at night.
Keep the troche under the tongue
The benefit of taking troche is the direct absorption of the hormones through the thin surface under the tongue. It is absorbed directly into the blood system, without passing through the digestive system and liver process. Taking a troche under the tongue increases the hormone absorption, and reduces the time for the hormone to take action. Some thyroid, melatonin, estrogen, and progesterone are prepared in troche form.
Depending on the type and the duration of hormone deficient, your body may need time to adapt to the newly replaced hormone. You should expect alleviation of the disturbing symptoms within a few days up to a few weeks.
Occasionally, you may experience fluctuation of the symptoms while your body is adapting to the therapy. Doctor may prescribe bio-identical hormones at lower dose to reduce the fluctuation, and slowly increase the dose over a few months.
A repeat hormone test might be needed after a few weeks to monitor your hormone level to avoid over-dosing or under-dosing, and to monitor your health improvement.
Most of the cases will require long-term bio-identical hormones to replace the missing hormones. In some cases, bio-identical hormones can be stopped or withheld after alleviation of the symptoms.
There are always other options. After the assessment, our medical doctor will discuss with you about your condition and treatment plan. The treatment plan will not only focus on bio-identical hormone therapy. It also includes other natural methods to restore your hormones level.
These important natural methods include personalised nutrition, phytohormone (plant hormone), and healthy lifestyle. In some cases, conventional synthetic hormones and medication might be preferred.
If you would like to know more about treatment option other than bio-identical hormone, please do not hesitate to discuss with our doctors.
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