Friday, April 30, 2010

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Tuesday, April 27, 2010

Hormones as Anti-Aging Supplements: Pregnenolone, DHEA & Melatonin

Being in an industry that is filled with marketing charades, we are biased toward being cautious, and, thus, are never going to be the first ones to announce the "new new thing"--whether ingredients hail from the rainforest or research labs.  Over-the-counter hormones--such as pregnenolone, DHEA, and melatonin--are far from new, but also bear cautious review.

I decided to ask my naturopath about hormones and the value of getting hormone tests to adjust either supplement regimens or bioidentical hormone replacement protocols.

Pregnenolone -- I was particularly interested in pregnenolone, which is often called a "mother" hormone, since it is a precursor to other important hormones such as DHEA, progesterone, estrogen, testosterone, and cortisol. Many of our members have written to me asking about pregnenolone.

When I asked, my naturopath said that pregnenolone is a tricky substance. Apparently, a small amount of pregnenolone (even at 5-10 mg) can yield fabulous results for some, increasing energy and "turning the clock back" in myriad ways (claims range from help with arthritis and depression to lowering cholesterol and improving memory and cognitive function).

Many people assume that pregnenolone gets converted into whatever hormone the body needs more of; however, that's not always the case.  In some people, alas, pregnenolone converts to the very hormone that is already dominant in the body and can thus lead to dreadful side effects that include racing hearts, insomnia, acne, thinning hair, etc. Some doctors advise against taking pregnenolone in amounts over 10 mg, but my naturopath was quite comfortable with a 25 mg amount for me as long as I didn't notice any unwelcome side effects.

Advice: Use with caution and under the supervision of a skilled healthcare practitioner.

Melatonin -- Circadian rhythm promoter, melatonin, is also a hormone, studied for its benefits in promoting sleep and time zone acclimation and also for protecting against cancer and age-related cognitive decline. Numerous studies have shown low melatonin levels to be correlated with both breast and prostate cancer and supplementation to be helpful in survival rates.

My naturopath was unequivocal: melatonin is good for people over 50, not only because improving sleep improves core immune function but also because melatonin is a potent free radical scavenger in its own right.

Many people enjoy better sleep with only 1 mg of melatonin; others sleep better with 3 mg. As with all substances, there are side effects associated with melatonin, especially when taking too much (some report sleep disturbances at levels that are considered therapeutic for other conditions).

Still, we have received positive feedback from trusted clinicians and researchers alike,which makes me happy, as melatonin is a supplement I take regularly. My naturopath was quite comfortable with a 3 mg amount of melatonin for someone my age (sigh, pushing rapidly out of my forties--how did that happen?!). 

Advice: Experiment with a portion of a tablet and see where you get the best benefits from melatonin for restful sleep. For other (estpecially more intensive) uses, consult with a healthcare professional.

DHEA --  DHEA is the most abundant steroid hormone in the body and can convert to both estrogens and androgens. DHEA has been studied for improving memory, addressing adrenal insufficiency, and decreasing evening cortisol levels (improving mood). Some researchers advise caution with hormones such as DHEA, which can boost estrogens and androgens and can, at least theoretically, affect cancer development.

I have tested too high in DHEA in the past (without a lot of supplementation). So I plan to be re-tested this summer to see what makes sense for my system this year.

Advice: Use with caution and, ideally, under the supervision of a skilled healthcare practitioner.

Hormone Testing -- I've been (happily) taking bioidentical hormone replacement for more than a year and wondered about the value of doing annual testing. I have heard from some doctors, even integrative doctors, that tests are too inaccurate and that it's mostly a matter of experimenting with dosages on an individual basis, noticing cause and effect in the body over time.

My naturopath, however, believes in annual testing and revising prescriptions accordingly, as hormone fluctuations during perimenopause are often quite dramatic. Hot flashes can as easily be caused by too much as too little estrogen. Surprisingly, some women (like me) have DHEA levels that are too high and don't know it untless they get tested. My naturopath advises sticking to a regular hormone replacement routine for six weeks prior to testing in order to stabilize levels of various hormones circulating; she sent me home with some simple instructions.

Advice: Don't spring for tests without a skilled healthcare practitioner's advice and instructions for getting an accurate reading.

For some things, we can just go on autopilot (i.e., water the plants once a week, take our same vitamins every morning, etc.). Other things require a little more attention, such as fireworks at Fourth of July celebrations and taking hormones to "turn the clock back."  I'm not trying to over-dramatize, just encouraging reflection and support from skilled practitioners when it comes to tinkering with hormones.

Drop a line here if you have thoughts about hormones, hormone replacement, and the like.