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Hormone Havoc: Bio-Identical, Synthetic or None?

by Dr. Michael Cheikin, MD

Sixty years ago women were convinced that bottle feeding was better for their baby than breast milk. Twenty years ago, women were told that menopause was a disease requiring artificial hormones for years, if not for life. Young girls are often given artificial hormones (birth control pills) as early as 11 years old to manage their menstrual symptoms.

When Premarin, a synthetic estrogen, was removed from the market due to cancer concerns women with menopausal symptoms were left high and dry. Along comes bio-identical hormones, which are (allegedly) the same as those produced by the human body. Men and women are given testosterone as an anti-aging strategy. Are bio-identical hormones safe, and how shall they be used?

What Are Hormones

Hormones are chemical messengers. As we evolved from single-cell to multi-cellular organisms, there became a need for cells to communicate with each other. Like an inter-office memo, one cell sends out a chemical messenger, which is then received by a second cell. That message tells the receiver to, for example, speed up or slow down (thyroid hormone), to take in more sugar or not (insulin), or to turn on or off certain genes.

As organisms evolved to greater complexity, like a high-rise office complex, this system of inter-office memos became too slow; and so a second signaling system developed--the equivalent of a phone or emai system--the nervous system -- where information is sent to specific places at great speed. Most of our hormones work slower and more generally than the nervous system, affecting every cell of our body by traveling through the blood stream. Each cell has a receptor on its surface that receives the hormone, like a key in a lock. These receptors can increase or decrease in quantity, or be turned on or off by numerous factors (see below).

Hormonal Systems Under Attack

The top ten prescribed medications in America include thyroid and diabetes hormones. Men's testosterone levels are declining with each new generation. Girls develop breasts as early as seven years old and puberty as early as nine years old, whereas 100 years ago puberty was at 17.

The reasons for this attack are multi-factorial. Toxins in our food, water, air and airwaves (EMF's, Electro Magnetic Fields) disrupt or confuse our signal systems. Deficiencies of essential nutrients don't allow nerve cells, enzymes, receptors and detoxification mechanisms to work properly. These deficiencies include omega-3 oils ("fish oils"), iodine, magnesium, zinc, several B vitamins and many others. Add the stressors of poor sleep, lack of proper exercise (including too much aerobics), and a culture based on consumption and we have an equation to cause dysfunction in every cell of our body.

Bio-Identical Hormones

"Bio-identical" hormones are identical to those made by our bodies. In contrast, Premarin is synthetic, named after its source, "Pregnant Mare Urine". These horse molecules were further processed by a drug company to enhance their effectiveness and make them proprietary. They were heavily marketed to physicians and women, with huge profit.

Bio-identical hormones are not marketed because drug companies cannot own them--the patent is held by God. Therefore, there is no money to be made on their manufacture or advertising. (Some patent-able delivery systems have enticed some companies to develop a few bio-identical hormone products). Medical research on bio-identical hormones is scant because, again, there is no proprietary product to be based on such research. Drug companies try to extend the concerns about synthetic hormones to bio-identical hormones, keeping the public confused and preferring pharmaceuticals. Many decades of experience by holistic practitioners suggest that these natural hormones are safer than the synthetic versions.

Are There Down-Sides to Bio-Identical Hormones?

Our hormonal systems are extremely complex and interactive. Each hormone has several forms. For example, thyroid hormone and estrogen have at least three or four forms, each with different roles. The body adjusts the ratio of these forms depending upon multiple factors. Many hormones also have "binding proteins", which essentially grab, store and escort the hormones throughout the body. Most hormone levels vary with the time of day, and other cycles, so tests need to be done at specific times.

When treating with bio-identical hormones, we can't mimic the natural 24/7 pattern of the hormones--at some times of the day levels will be too low or too high. Each hormone also has an optimal formulation for absorption--such as by mouth, skin, injection, or other means. Finally since most hormones affect each other, prescribing one hormone often requires adding others, with frequent monitoring and adjustment.

This complexity was pointed out by a male patient who was started on bio-identical testosterone replacement after discovering that his levels were low. While he felt great on this treatment, his testicles began to shrink! And when his implantable pellets began to run out at the end of the month, he would begin to feel horrible--and would have to rush to the doctor to have new pellets implanted. In essence, he had become a "testosterone addict".

Even conventional medicine knows that when we give the body hormones, such as cortisone, the producing glands take a vacation. Externally provided hormones can't be stopped abruptly, but must be gradually withdrawn to enable the related glands to ramp up their factory. Often the glands have gone on retirement and cannot resume production at adequate levels.

Hormones during Menopause and Andropause

As a women approaches menopause, the ovaries reduce production of female hormones, and the adrenal glands and other tissues (such as the liver) need to take over most of this function. Men experience "andropause", an analogous decline in testosterone levels with associated symptoms.

Some people sail through this transition, while many experience numerous difficulties. This variability is dependent in part upon how the adrenal glands are working, as well as the toxicities and deficiencies discussed above. If the systems cannot respond to the demand, a host of common symptoms ensue, including fatigue, poor healing, depression, anxiety, hot flashes (both men and women), low or high blood pressure and increased glucose and cholesterol.

So What Are We To Do?

20,000 years ago, all that we needed was provided by our lifestyle. All our nutrients are provided by the environment. There were vastly fewer toxins. Periods of stress were followed by periods of rest. We had seasons of light and warmth followed by seasons of dark and cold. The body has millions (if if not billions) of years of wisdom encoded in genes, epigenes4 and other systems of self-regulation, which cannot be fully understood or mimicked by human "intelligence".

When it comes to hormones, the mantra should be "less is more". By eliminating toxins (food, water, air, EMF's), getting good nutrition (organic foods and proper balance of supplements), good sleep, good exercise (such as yoga and walking), and good stress reduction by achieving balance in work, community and spirit, people feel better without having to add hormones. Acupuncture and other energy treatments can also be helpful.

However, if, after six months of gentle support, there is insufficient improvement in symptoms (and lab tests), we have the option of special tests, special herbs and supplements, and if necessary, small amounts of hormones and other compounds that support the glands while returning to balance. Treating with hormones is complex, since most hormones affect each other, in a web-like fashion. Regular testing and adjustment is usually necessary as our systems change with the seasons, stressors, and stages of life.


1. This educational material may not be used to influence medical care without supervision by a licensed practitioner.

2. These contents may not be reproduced in any form without express written permission. © 2007-2018 by Michael Cheikin MD

3. Dr. Cheikin's website has related articles such as "Hormonal Web" "Adrenal Fatigue", Thyroid Epidemic" and others.

4. Epigenes are molecules that modulate expression of genes and which are transmitted from generation to generation apart from genes. They code recent experience, while DNA codes past experience.

Michael Cheikin MD is a holistic physician, Board Certified in Physical Medicine and Rehabilitation ("Physiatry"), Pain Management, Spinal Cord Medicine and Electrodiagnostic Medicine and licensed in Medical Acupuncture. Dr. Cheikin has extensively studied yoga, diet and metabolism, Ayurvedic, Chinese and energy medicine and other alternative modalities for over 30 years. He specializes in obscure, chronic and severe problems that have not responded satisfactorily to other methods of healing. www.cheikin.com

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