I am an holistic GP on the Sunshine Coast with a strong interest in functional medicine. As such I help my patients achieve optimal health in the best ways I know how. Hence I use the finest of both what complementary and conventional medicine can provide. What is more, I like to work with good naturopaths such as Danielle Roberts and Kim Carolan. We get some very good results with bio-identical hormones.
We believe in the power of nutrition and lifestyle modifications to achieve optimal health. Yet I see numerous patients who also need some additional help. For example, some people with very good diets and lifestyles still have symptoms of hormonal imbalances. This stimulated my interest in hormonal therapy.
Women often ask me about bio-identical hormones.
What are “Bio-identical Hormones?”
There is a common misconception that bio-identical hormones are natural products. Yet with the exception of desiccated thyroid hormone, this is not exactly true. So, what is the difference between conventional hormone therapy and bio-identicals? Conventional hormone therapy typically makes use of synthetic hormones (often animal-based hormones) that have a slightly different chemical configuration from human hormones. This can result in unwanted or adverse consequences, and may account for some of the risks we associate with hormone administration. “Bio-identical” hormones are synthesised in a lab, yet have the same biochemical structure as the ones in our own bodies.
What symptoms may improve with Bio-identical Hormones?
Unwanted weight gain
Vaginal Dryness and Discomfort
How are they used?
There is a broad range of possibilities available on the Sunshine Coast for the administration of bio-identical hormones. For example, there are different troches (lozenges), oral capsules and creams. Oestrogen probably has a safer risk profile when administered transdermally. We use progesterone in different ways depending on the clinical situation. I usually use testosterone as a cream. We give thyroid extracts orally.
This is an evolving area with many different opinions. I have my own conclusions, but they are likely to change based on evidence as it becomes available. While I do appreciate that specialised hormone testing can be expensive, I wish to make the use of BHRT as safe as possible. So to establish a true hormone deficiency is a necessity. This is best done using a comprehensive symptom assessment. It is also helpful to do an initial serum hormone level screening.
Once BHRT is commenced, the DUTCH Test (a dried urine hormone test looking at metabolites) is available on the Sunshine Coast. It helps monitor adverse outcomes.
How I use them to achieve optimal health, and how my approach may differ from other practitioners.
The control system for hormone regulation is a delicate and complicated feedback loop. It is known as the HPA axis (the hypothalamic-pituitary-adrenal axis.) Hence we monitor this hormonal feedback. So, an holistic GP and good naturopaths take a comprehensive look at the patient on multiple levels. This is much more useful than to just replace an identified hormone deficiency. With this in mind, I utilise a 3 step process to help maximise good outcomes and prevent unwanted side effects.
Step 1 – Holistic Doctors and Good Naturopaths Address Lifestyle Issues
As an initial measure, good naturopaths and I always address lifestyle measures that effect hormone balance. Some of these include:
Exposure to toxins
Lack of exercise
Lack of sunlight, a surprisingly common problem on the Sunshine Coast
Certain prescription and over-the-counter medications
These factors go a long way to tackle and target co-existent abnormalities.
I have a particular interest in gut health. It is easy to overlook gut health as it relates to hormone regulation and production. For instance, the wrong types of bacteria in the gut can lead to increased intestinal permeability and secondary inflammation. This inflammation suppresses the function of the hypothalamus and pituitary in the brain, which in turn affects the production of hormones like oestrogen and cortisol. what is more, inflammation can also cause hormone resistance in some circumstances. This is why an holistic GP and good naturopaths cannot afford to ignore the gut.
Additionally, there is a relatively new concept described as the “oestrobolome.” This refers to “the aggregate of gut bacterial genes that metabolise oestrogens.” In other words, abnormal gut bacteria may predispose or promote the metabolism of oestrogen into toxic forms. Most importantly, an holistic GP and good naturopaths know that this may promote the development of malignancies such as breast cancer. This is why we address gut health.
Step 2 – Nutritional Support and herbal therapies.
This area is where I think our integrative approach at Pulse Holistic Medical on the Sunshine Coast stands out. To that end, as an holistic GP, I often like to work collaboratively with our good naturopaths, Danielle Roberts and Kim Carolan. So I rely on their extensive knowledge of supplements and herbal remedies to help achieve optimal health in our patients. So in some instances, this may mean that no hormones are required. Yet if we still feel that patients will benefit from BHRT, we put these measures in place, which adds to successful outcomes.
Step 3 – Bio-identical hormones therapy.
After I address steps 1 and 2, a trial of bio-identical hormones may be warranted to achieve optimal health. To this end, I use the lowest dose and for the shortest duration of time to achieve optimal health.
This 3-step process is only a rough guide. So sometimes a trial of bio-identical hormones may be necessary to provide rapid relief from symptoms. What is more, lifestyle improvements can still occur simultaneously. So we can always re-evaluate the need for further BHRT at a later date.
Dr Tim Smith, holistic GP.
I work at Pulse Holistic Medical Centre in Minyama on the Sunshine Coast.