In the April 16, 2008, issue of the Journal of the American Medical Association (JAMA), the editor Dr.Catherine DeAngelis said that misleading pharmaceutical drug research is often published in major medical journals and doctors are lending their names to it. Doctors, regulators, publishers and others are all taking money, information and small presents from pharmaceutical companies and being influenced in the process.

            JAMA published a paper accusing Merck and Co. of suppressing data that showed its now-withdrawn pain drug Viox was harming patients, and saying that academic researchers had lent credibility to the company’s allegedly manipulated research by putting their names on the work. Merck and the independent researchers have denied this and say the journal is mistaken in this case.

Dr. DeAngelis said there is a “gigantic” problem of drug companies influencing doctors and patients. Her journal presents the Merck case as a specific example of one facet of the problem. “We have given away our profession and we have got to take it back,” she said.

In our current medical system, large drug companies provide money and influence to direct the opinions of doctors and patients. Drug companies make money by patenting new substances to supposedly be the next big cure. Often that new drug comes with a big price to health.

The recent attack on cholesterol, making it public enemy number one, is a case in point. We are barraged by TV commercials for statin drugs like Lipitor and an obsession with “high cholesterol”.  But complications of taking statin drugs can be serious including memory loss, muscle aches and pains, and myopathies.  One of the ways statins do this is by blocking the production of CoEnzyme Q10, necessary for these functions in the human body.  Cholesterol can be lowered with proper diet, exercise, specific nutrient supplementation, and bioidentical hormone replacement. If cholesterol is lowered too much with medications, it can affect hormone balance and quality of life because cholesterol is the base substance for the production of estrogen, progesterone, and testosterone.  

  The recent attacks on bioidentical hormone replacement have also originated in drug companies who see a dwindling bottom line as patients turn away from their dangerous synthetic hormones toward safer but non-patentable biodentical hormones.

The best medicine is preventative. Therapeutic lifestyle changes including a healthy diet and exercise are the basis of good health. Replenishing lost nutrients and hormone deficiencies keep your body working right and feeling good, and off pharmaceutical drugs.

Candice Lane, M.D., 1250 La Venta Dr., Ste 206, Westlake Village, CA, 91361,

805-496-7869.

Fellow and Diplomate American Academy of Anti-aging Medicine

          Heather Locklear returned home on July 23, after spending a month in a spa-like treatment facility in Arizona for anxiety and depression. Articles imply she was already on medication and needed it adjusted. Certainly her recent public divorce is a reason for situational depression.

          With all due respect, I have one question. Has Heather had her hormones checked?  Now this might bring a collective groan, but think about it. Locklear is almost 47, well into the perimenopause and hormone loss. She looks young and beautiful, but our bodies have a relentless “biological clock” that cannot be ignored. We know that testosterone and progesterone are the first hormones to decline. Testosterone is linked to maintaining emotional shield and may prevent panic attacks. Progesterone deficiency causes irritability, mood swings, depression, and insomnia. Progesterone has a calming effect on the body by stimulating the calming GABA receptors in the brain. Add a little loss of estrogen which stimulates calming serotonin production, and emotional lability, weepiness, and depression can follow. Added to this is that the FDA has warned that anti-depressants themselves may increase depression and suicidality.

Medications like hormonal birth control or Prempro only make matters worse because progestins in these medications inhibit the production of the body’s progesterone and occupy progesterone receptors. I have had several patients lately on hormonal birth control come in with depression. They are on things like Mirena and Nuvaring, both of which secrete potent progestins (not progesterone) in the circulation that occupy progesterone receptors and deplete progesterone thereby preventing the calming effect of progesterone and natural hormonal balance. This effect may be more pronounced as we get older, since we are also losing our progesterone by our ovaries beginning to shut down. Post-partum depression is associated with a drop in progesterone after childbirth. Giving progesterone post-partum can prevent this depression.

          Stress makes matters worse. When we have stress our adrenal glands increase our production of cortisol which is our hormone that controls our daily sleep-wake cycle and our fight or flight response. The body will use all its resources to make cortisol, a hormone we cannot live without.  The body uses progesterone to help make cortisol, so stress situations may make progesterone levels lower. This may be the connection between stress and infertility. Chronic stress gives way to fatigue as the body struggles to keep up with the stress demand. Both adrenal stress and fatigue can further intensify depression through fluctuations in cortisol and progesterone. Relaxation may allow temporary improvement, but the perimenopausal body still continues its relentless progesterone and estrogen decline. In addition, adrenal fatigue and stress may effect thyroid function by altering the efficiency of how thyroid hormone is working in the body. Low thyroid function can cause depression. So treating hormone deficiency has to take all the hormones into account.

          All this may sound confusing, but it works. I recently had a patient that was on a few antidepressants and seeing a therapist. She balanced her hormones and within a few months got off all her medications and is feeling great. I personally had that experience as well. After 10 years of anti-depressants and counseling to no avail, I started on bioidentical hormones for perimenopausal hormones loss. I was able to get off all anti-depressants and am doing  better than ever with mood and outlook. (That’s an article in itself but we’re talking crying at the drop of a hat, irritable on the road and in parking lots, and general helpless and hopeless to doing just fine.) 

          Suzanne Somers’s has called anti-depressants, sleeping pills, and pain medicine, the “menopause cocktail”. As a former member of that club, I can attest to the truth of it. Initially, being uninformed and thinking I was still “young”, I did not put it together. It was only through proactive seeking that I found what was missing and that was my hormones. I recommend a good reading of Suzanne Somers’s “Ageless”. With bioidentical hormone replacement we can treat the underlying cause of our mid-life perimenopausal changes and be ourselves again.

Candice Lane, M.D.,  Diplomate and Fellow American Academy for Anti-aging Medicine, 1250 La Venta Dr., Ste.206, Westlake Village, CA 91361, 805-496-7869, 877-496-4289

Elderly women are at greater risk of death after a hip fracture than after breast cancer, according to a recent article in Medscape Medical News citing a study by Jane A.Cauley, DrPH,  at the University of Pittsburgh. The death rate was 48.1% after a hip fracture versus 25.1% after a breast cancer diagnosis.

What causes hip fractures?  Osteoporosis! Women with osteoporosis are the most likely to sustain a hip fracture. Osteoporosis advances rapidly after menopause due to the dramatic drop in hormones.

According to the National Osteoporosis Foundation, half of the women over 50 will have an osteoporotic fracture before they die. Half of the women surviving a hip fracture will not be able to walk and a quarter will need long term nursing care. A woman’s risk of hip fracture is equal to her combined risk of developing breast, uterine, and ovarian cancer.

Women are not the only ones who suffer from this problem. Men also get osteoporosis, although it is poorly recognized by the medical community.  Men typically develop osteoporosis slower and it appears later than in women.  Testosterone begins to diminish in the early 30’s and decreases 1-3%  per year, increasing the risk for bone loss. Men over 65 have a hip fracture rate of 5 in 1,000. Men over 65 are at risk and should have a bone density test done, as well as calcium, magnesium, thyroid, Vitamin D, and hormone levels.

            By 2010, over 52 million men and women age 50 years and older will either have osteoporosis or be at increased risk because of low bone mass per the National Osteoprosis Foundation. Approximately 20% of those that develop hip fractures will die the year after the fracture from surgery complications such a pneumonia or blood clots in the lung according to the CDC.

            The best therapy for osteoporosis is replacing lost hormones. In women, estrogen saves more bone tissue than very large doses of calcium according to the National Institute on Aging. In the May 2004 Journal of the American Medical Association, British researchers described a link between hormone replacement therapy and a reduced risk of bone fracture in post-menopausal women.

            Poor nutrition and inadequate intake of nutrients, lack of adequate exercise, unhealthy lifestyle including cigarettes and alcohol, and race also contribute to osteoporosis. Hormone replacement in men and women is of key importance for bone health.

            Replacemen with biodentical hormones is key. All three hormones are necessary in order to build and maintain bone: estrogen, progesterone, and testosterone. If you are taking Premarin, you are only getting an estrogen effect, and a dangerous one.You don’t want to trade one problem for another by taking alien synthetic molecules orally, like Premarin and Provera,  that can increase heart disease, stroke, and breast cancer. Remember all estrogen, even bioidentical, should be taken transdermally. Any oral estrogen can increase C-reactive protein which correlates with a higher incidence of heart disease. Provera or medrxyprogesterone has no benefit for bone, and in fact inhibits beneficial progesterone production and effects by binding to progesterone receptor sites.

            The synthetic pharmaceutical medications for osteoporosis, like Fosamax, are problematic. They do not allow for the natural turn-over and remodeling of bone and what you essentially wind up with is a lot of old brittle bone. In addition, one study showed that combining estrogen with Fosamax may increase fractures. In addition, Fosamax is correlated with bone problems in the jaw.

           Vitamin D is very important to build bone and prevent osteoporosis. Even in the sun belts, Vitamin D levels are low among men and women due to interior jobs, sun-screen over-use, and lack of ability of aging skin to convert sunlight to Vitamin D. Get your 25 hydroxy Vitamin D levels checked with a blood test, and if they are low step up your supplementation until they come up.

             Nutrient supplementation needs to be more than just calcium to build bone. Calcium citrate is OK, but calcium hydroxyapetite is best. Don’t exceed 1600 mg total of calcium per day unless you want calcium in your arteries and kidneys too. Other important nutrients for bone building are Vitamin K, magnesium, manganese, boron, and strontium. Othomolecular makes a great supplement that has all you need for bone maintenance or improvement of osteoporosis called ProBono. Patient report joints feeling better on it as well.

            Make sure you get a baseline bone density scan when you are in the perimenopausal years so you know where you are starting out. If you have osteopenia, take action. You can prevent osteoporosis!

Candice Lane, M.D., 1250 La Venta Drive, Westlake Village, CA 91361, 877-496-4289, 805-496-7869.

The latest Indiana Jones movie disappoints me with the shuffling, slurring, grumpy old man that used to be Indy. In contrast, Sly Stallone’s last Rambo is as physical and dynamic as ever. My 17 year old dubbed Ford an old man, but pegged Stallone as in his 40’s. Playing action figures, both men are in their 60’s. What’s the difference? Growth hormone and testosterone.

When Rambo came out in January 2008, Stallone publicly admitted to using growth hormone and testosterone. “HGH (human growth hormone) is nothing,” the 61-year-old actor told Time Magazine in its Feb. 4 issue. “Anyone who calls it a steroid is grossly misinformed. Testosterone to me is so important for a sense of well-being when you get older,” he says. “Everyone over 40 years old would be wise to investigate it because it increases the quality of your life. Mark my words. In 10 years it will be over the counter.”

Thank goodness a prominent male celebrity has the guts to talk about hormone health for men!

Sly is right! Growth hormone is not a steroid and testosterone and growth hormone are very important to quality of life in men over 40. Both growth hormone and testosterone get a bad rap due to sports figures over-using them to gain unfair advantage. We are not talking about abuse with synthetic, liver-toxic poisons sold in the back rooms of gyms. We are talking about molecularly bioidentical growth hormone and testosterone native to the human body given in healthy physiologic amounts.

With age, men steadily lose both these hormones starting at about age 30. By the time a man is 60, he may have only ¼ the testosterone and growth hormone of a 25 year old man. This is nature’s way of shutting us down, except we stay alive due to our living conditions and disease-oriented medicine. You may have normal hormone levels for a 60 year old, but this is not optimal for health. The healthiest adults are in their 20’s, who have optimal levels of testosterone and growth hormone.

Human growth hormone is biosynthetic and has the exact same molecular structure as in the human body. It is responsible for growth, healing, immune function, increased muscle mass, minimizing body fat, controlling cholesterol, maintaining sexual energy, and increasing bone strength. It improves heart function and cognitive ability including memory, alertness, motivation, work capacity, speed of information processing and sociability. Growth hormone replacement at physiologic levels does not cause cancer. Growth hormone acts synergistically with testosterone in that their beneficial effects together are greater than either one alone. Growth hormone is approved for use in Adult Growth Hormone Deficiency, which is a common occurrence in adults over 40 years old.

Decreased testosterone in men results in increased aging of the heart and circulation including increased heart attacks and strokes. There is increased brain aging with decreased memory, decreased intelligence, increased dementia, and increased Alzheimer’s. Men lose their drive and competitive edge.  They get stiffness and pain in muscles and joints, decreased effectiveness in workouts, and a falling level of fitness. In addition they get more fat and less muscle, osteoporosis (yes, like women), and anemia. Fatigue, depression, mood changes and irritability (grumpy old man syndrome) are common. And of course, there is reduced libido and potency. Testosterone does not cause prostate cancer.

These declines in men happen more gradually than menopause and often become accepted as “just getting old”.  Sadly, some men perceive hormone loss as a matter of ego instead of health. Remember, we may get old, but do need to feel old!

Candice Lane, M.D., 1250 La venta Dr., Ste. 206, Westlake Village, CA 91361. 805-496-7869,877-496-4289.

Tired of fighting the battle of the bulge? Following a strict diet and exercising, yet still unable to lose weight. You may be suffering from hormone imbalance.

There are several hormones that contribute to weight control.

Most of us know about how increased stress hormone, cortisol, can increase belly fat. But several other hormones contribute to weight gain and inability to lose weight.

In women, lack of progesterone, that is natural bioidentical progesterone, not progestin, can cause you to gain weight. Estrogen is responsible for 400 functions in the female body, but without progesterone to modulate the building up effect of estrogen, you will gain weight. Both estrogen and progesterone fall with age, but progesterone goes first leaving most women with a relative estrogen excess in comparison to progesterone. Estrogen without enough progesterone can cause a weight gain of about 10 pounds. Progesterone is a natural diuretic and modulates this effect of estrogen, making it easier to lose weight.

Another hormone deficiency that increases weight gain in men and women is lack of thyroid hormone. The active thyroid hormone to lose weight is T3, but most doctors measure the inactive hormones T4 and TSH, giving an inaccurate view of thyroid function. In addition, parameters for normal are too broad. You may also be thyroid hormone resistant due to yo-yo starvation diets, stress, and nutrient deficiencies. To make matters worse, thyroid hormone naturally decreases with aging. A thorough thyroid blood work evaluation can detect if your weight problems are due to lack of thyroid hormone.

Lack of testosterone in women, but especially in men, can cause weight gain. Testosterone helps to build up muscle which burns fat. In men testosterone improves energy to exercise, burn fat, and build muscle.

DHEA is another hormone that helps to lose weight. Studies have shown people who take DHEA have more success losing weight than those who do not. DHEA helps burn fat, raise metabolism, decrease appetite, and decrease fat storage in and of itself.

Last but not least is adult growth hormone deficiency.  Growth hormone helps to increase lean body mass, and decrease fat mass. It improves energy and outlook including desire and ability to exercise. It increases muscle mass which increases fat burning.

  Hormones and nutrients go hand in hand and there are many nutrients that help lose weight including chromium, CLA, GLA, zinc, selenium, green tea, ginseng, and Co Q 10, among many others.

Of course, diet and exercise and very important to weight loss as well. If you feel you’re doing everything right but can’t lose weight, check you’re hormones.

Candice Lane, M.D., Diplomat and Fellow American Academy for Anti-Aging Medicine, 1250 La Venta Dr., Ste. 206, Westlake Village, CA 91361.805-496-7869.

As we age we lose our hormones. All of our good building up hormones start declining after age 30.   Cortisol and insulin tend to increase, which can harm our health. These changes are detrimental to our vitality and our health.

These hormone changes are part of the cycle of life, a building up and then shutting down. Hormones are the highest in our most vital and healthy time of our life, our teens and twenties when we have our highest energy and best health, our “child-bearing years”. After this time, about age 30, our genetics dictate that our good hormones decline: testosterone, estrogen, progesterone, thyroid hormone, and growth hormone.  Hormones that can harm us, cortisol and insulin, start to rise.  At about age 40, hormone decline accelerates in women as the ovaries begin shutting down hormone production in the peri-menopause. Men’s hormones continue to decline. This is nature’s way of shutting us down and eliminating us. It is not a coincidence that the healthiest time of our lives is when we have our full complement of hormones, nor that we begin developing the diseases of aging, heart, bone, brain, and eye problem, as our hormones decline. We age because we lose our hormones!

This was not as issue prior to 1900, when the average age of death was 50. Most men and women did not experience the full force of hormone loss. Now with the average age of death at 80, we can live 30 years or more without our hormones and the consequences.

Certainly, lifestyle, exercise, body weight and exercise, nutrient supplements all contribute to being healthy and may help make the process of hormone loss easier or make certain hormone loss slower. But none of these things will put your hormones back. Acupuncture, chiropractic, yoga, and Aruvedic medicine may also help alleviate hormone symptoms, but none will not put your hormones back. The only way to keep your youthful compliment of hormones is by replacing them, and only with hormones that have the same exact molecular structure that is native to the human body.

When we enter our 40’s women start feeling these changes as ovaries start to shut down production of sex hormones in peri-menopause and menopause. Nature is most cruel to women because symptoms of perimenopause can be swift and profound. Menopause has been often likened to falling off a cliff where men’s andropause is likened to rolling down a hill. Men begin noticing the more gradual decline in testosterone called andropause. Meanwhile thyroid hormone and growth hormone also declines.

In women testosterone is the first to start declining, then progesterone. In their 40’s, women start noticing insomnia, irritability, mood swings, depression, low libido, hair loss, and migraines directly associated with low progesterone. Estrogen also starts declining, but is the last to go with hot flashes, weepiness, night sweats, and lack of energy. The symptoms of hormone change can continue for 15-20 prior to loss of menstruation.

With loss of testosterone, men experience fatigue, memory loss, loss of libido, loss of muscle mass, weight gain, decreased athletic ability, muscle aches, and decreased interest in activities.

Thyroid hormone and growth hormone play vital roles in hour health and energy as well, and need to be replaced and even optimized (but not abused) when deficient with bioidentical equivalents.

Bioidentical hormone replacement will alleviate the symptoms of menopause and andropause.   I am often asked, “Do I have to take them forever?”.  The answer is yes. If you stop taking hormones all your symptoms will come back. Once you stop making your hormones, they are gone. They do not come back unless you put them back with bioidentical hormone replacement.

The long term consequences of lack of hormones are weight gain, loss of muscle mass, heart disease, high cholesterol, diabetes, colon cancer, macular degeneration, cataract formation, high blood pressure, and osteoporosis. A lower chance of having these problems keeps me happily taking my hormones and vitamins each day.  I also feel the same way I did in my 30’s!

We all will die some day. The fact is that our cells can only divide so many times. Each time they divide they lose some DNA, and when a critical limit is met, they die. Current maximum age is believed to be 120 years due to this effect.

Of course we have to fuel our cells with nutrients and vitamins, limit our exposure to toxins and chemicals, and detoxify. 

We are living longer because we have great living conditions and can prevent mortality from many diseases and accidents. But most of us will feel lousy for the last 30 years struggling with symptoms and disease until we come to accept our age and poor state of wellness. 50% of those who live to be 85 will have Alzheimer’s (estrogen can prevent Alzheimer’s disease).

It doesn’t have to be that way. With bioidentical hormone and nutrient replacement you can enjoy feeling good for the rest of your life. The means is available. The choice is yours.

Candice Lane, MD, Diplomate and Fellow American Academy for Anti-aging Medicine, 1250 La Venta Drive, Suite206, Westlake Village, CA 91361, 877-496-4289, 805-496-7869.

We often think of emotional health in terms of what’s going on in our lives, but more often it is tied to what’s going on in our bodies.

Emotional health is very much tied to our hormones. Depression in particular can be governed by deficiencies and imbalances in our hormones.

In men, testosterone deficiency is linked with depression, irritability, and lack of motivation. The term “grumpy old men” is often used to describe the emotional changes that occur in men with testosterone deficiency. In women, lack of testosterone can be associated with lack of emotional shield and panic attacks.

In women, estrogen enhances formation of serotonin and estrogen deficiency can cause depression, but lack of progesterone is also tied to depression, irritability, and mood swings. With decreasing estrogen and progesterone in the pre- and peri-menopause it makes sense why women experience more depression in mid-life. Lack of estrogen can also effect concentration and memory.

 Post- partum depression is really a disorder of a precipitous drop in progesterone after childbirth and inability to rebound from this drop. Some informed obstetricians treat this change in mood not with anti-depressants but with bioidentical progesterone with great success.

 Many young women on the birth control pill or other forms of hormonal birth control experience increased depression, irritability, and mood swings. This is because the synthetic hormones in these drugs interfere with normal hormone balance, occupying normal progesterone receptors in addition to decreasing the production in progesterone eliminating the natural calming effect of this hormone.

Another hormone that can affect emotional health is cortisol (the stress hormone) excess or deficiency. These conditions can cause irritability, confusion, sleep disturbances, mood disturbances, depression, emotional imbalances, foggy thinking, and panic disorders.

Thyroid hormone deficiency can also cause depression, anxiety or panic attacks, decreased memory, inability to concentrate, slow speech, insomnia, and agitation.

Growth Hormone deficiency can also manifest not only as a lack of motivation but also as a lack of sociability.   In addition, a prominent characteristic of low growth hormone is an inability to concentrate and a failing memory.

A deficiency in any of our major hormones can have mental and emotional effects. The best way to determine if hormone loss is a factor in your mental health is to see a doctor familiar with the emotional effects of hormone loss, discuss your symptoms, and have hormone testing. If deficiencies are detected, replace lost hormones only with bioidentical hormones. It could make all the difference!

Candice Lane, M.D., 1250 La Venta Dr., Ste.206, Westlake Village, CA 91361, 805-496-7869.

There has been a lot of buzz about women’s hormones, but you hear very little about men. To make it worse, men do not seek or share this information as women do. How many men do you know who go out for coffee with their buddies and talk about their hormones? Few people appreciate the pervasive effects of testosterone on men’s general health.  

The fact is that as men age, they lose their testosterone. The loss of youthful levels of testosterone with the onset of its associated symptoms is sometimes called andropause. It is the natural diminution (or pause) in production of male hormone (an androgen) as men age.

Testosterone loss in men is a gradual process. Testosterone decline starts around age 30, and may drop 1% to 3 % per year depending on genetics and lifestyle. That means that men can sustain a 20% drop in testosterone by age 50, and a 50% drop by age 80. Each man may experience the symptoms of a decline in testosterone differently depending on what his normal was at his hormonal peak.  Often the symptoms are ignored or rationalized away until the resultant decreased functioning becomes a way of life.

The most obvious and disturbing changes for men are those of sexual function, but equally troubling symptoms of low testosterone may manifest as a decline in mental functions, musculoskeletal conditions, and metabolic or physical diseases.

Changes in mental functioning may manifest as spells of mental fatigue and inability to concentrate, feeling burned out, low energy, tiredness or sleepiness in the afternoon or evening, decrease in mental sharpness, attention, and wit, or a change in creativity like getting spontaneous new ideas. There may be a decrease in desire to start new projects, or a decreased interest in past hobbies or new work-related activities.  Competitiveness may diminish and irritability increase. Memory functions may become impaired with increased forgetfulness. Men can experience a sense of depression with a sense that work, marriage, or recreational activities have lost their significance.

Musculoskeletal symptoms may appear as sore-body syndrome with aches and joint and muscle pains. A decline in flexibility and mobility may be noticed with increased stiffness. Muscle size, tone, and strength may decrease. Physical stamina and athletic performance may decline. Some men experience back pain, neck pain, or a tendency to pull muscles or get leg cramps. Some develop osteoporosis or inflammatory arthritis.

Low testosterone levels correlate with more risk factors of heart disease than any other individual factor in the male body. Cardiovascular risk factors increase in men as testosterone decreases.  Cholesterol and triglyceride levels increase, coronary and major arteries constrict leading to a greater risk of cardiac events, and blood pressure rises. Insulin resistance increases with obesity, adult diabetes, and increased cortisol levels. There is increased central abdominal fat with increased waist to hip ratio. Estrogen levels associated with higher stroke and heart attack rates (and increased fat in the breast and hip area) increase. Another increase associated with decreased testosterone is in lipoprotein A and fibrinogen, which correlate with cardiac events. Also, human growth hormone output decreases leading to a decline in energy, strength, stamina, and heart muscle mass and output. Low testosterone levels are associated with increased incidence of death even after researchers adjust for age, medical problems, and variables.

Although not all signs and symptoms of aging are due to hormonal decline, many correlate well with a decline in hormones and can be alleviated by hormone adjustment.

Treatment of low testosterone should be administered by a doctor trained in hormone therapy after a full history, examination, and laboratory testing. Regular follow-up is important to control symptoms, prevent side effects, and to make sure hormone levels are optimal.

Dr. Candice Lane is a physician specializing in hormone replacement therapy. She is a Diplomate and Fellow of the American Academy for Anti-aging and Regenerative Medicine. Her practice is at 1250 La Venta Drive, Ste. 206, Westlake Village, Ca 91361. 805-496-7869.

As we age we lose our hormones. Most people think about this in relationship to estrogen, progesterone ad testosterone, but thyroid hormone production decreases with age as well. In addition, hormone changes and nutrient deficiencies may exacerbate thyroid hormone deficiency.

Symptoms of hypothyroidism include fatigue, loss of energy, weight gain, difficulty losing weight, depression, dry skin, brittle nails, brittle hair, itchy scalp, hair loss, cold intolerance, constipation, puffy eyes and face, tingling in the wrist and hands, elevated LDL cholesterol, memory loss, fuzzy thinking, loss of sex drive, slowness of speech, hoarseness, muscle and joint pain, and headaches.

Subclinical hypothyroidism may present itself with mild symptoms or just fatigue which needs to be differentiated  from other hormone deficiencies such as estrogen or cortisol.

To complicate matters, hormone changes such as elevation or decline in cortisol from adrenal stress or fatigue, and imbalances in estrogen can affect the production and availability of thyroid hormone. In addition, deficiency of iron, B vitamins, iodine, selenium, and zinc can also have a negative effect.

Thyroid deficiencies are often under-diagnosed since most practitioners only measure TSH and T4 hormones as a gauge of function. The body converts T4 to the active hormone T3. With nutrient deficiencies, you may not be able to adequately convert T4 to T3.  In addition active T3 can be diluted by an inactive molecule called reverse T3, usually present more commonly in stress. Neither T3 or reverse T3 are usually measured. Thyroid antibodies are other tests also usually ignored. Elevated thyroid antibodies called Hashimoto’s disease, indicate the thyroid is making antibodies against itself. Although many physicians feel it is not necessary to treat this condition, others feel that it results in inconsistent thyroid hormone production that needs support.  

Thyroid replacement should be given as a combination of T4 and T3 (Armour thyroid or compounded T4 and T3), instead of T4 (Synthroid) alone. Again, if you are unable to convert T4 to T3, then T4 alone will not help. In cases of high reverse T3, it is best to replace T3 alone.

The symptoms the patient is having may often be the best guide to treatment.

Candice Lane, MD, 1250 La Venta Dr., Ste. 206, Wesrlake Village, CA, 91361, 805 496-7869, 877-496-4289.