Hormones and well-being


Are you low in Vitamin D?

Vitamin D3, or cholecalciferol

What is Vitamin D?

Vitamin D is not technically a vitamin at all, but rather a kind of hormone that is essential for life.  It increases the absorption of calcium from foods in the gut, promotes the healthy growth of bone, and is important for the absorption of iron, magnesium, phosphate, and zinc. It also has beneficial effects on nerve, muscle and immune functions.

Vitamin D deficiency

Normally, Vitamin D is made by your skin following exposure to ultraviolet light in sunlight (UV-B). Overseas, Vitamin D is added to dairy and other foods as a supplement, but in Australia the only mandatorily fortified food in Australia is margarine. In southern Australia (>35ºS in latitude), as much as 58% of the adult population is Vitamin D deficient during winter, due to insufficient sun exposure (due to indoor lifestyles and “Sun Smart” skin cancer prevention) and low dietary intake. Deficiencies are more common in the elderly population.

In vitamin D deficiency, bones can become thin, brittle, or misshapen over time — classically seen in the diseases rickets (in children) and osteomalacia (in adults). Older adults are particularly at risk of osteoporosis without sufficient Vitamin D and calcium. Improving vitamin D levels in the elderly reduces their risk of falls and bone fractures, through improving balance and strengthening muscles.

Increasing Vitamin D levels using sunshine

The amount of daily sunshine you need on your skin to make enough Vitamin D depends on your skin colour, your location and the season. For moderately fair-skinned people, adequate vitamin D levels may be achieved through summer exposure of the arms (or equivalent) for 6-7 minutes during mid-morning or mid-afternoon. In winter this is increased to 7 to 40 minutes (the longer times are for more southern latitudes) at noon on most days, with as much bare skin exposed as feasible. People with darker skin require exposures that are 3-6 times longer.

Clearly many people cannot receive sufficient sun exposure, especially during a rainy southern winter. For many Australians, supplementation is advisable for at least a part of the year.

Vitamin D supplementation

If you are prone to Vitamin D deficiency, you should have your levels checked every 3-6 months, or as recommended by a doctor.

A daily oral intake of 600-1,000 IU of Vitamin D3 is sufficient for most people, but higher doses may be required in moderate to severe deficiency. Talk to your doctor about high-dose vitamin D (e.g., 50,000 IU taken once a month).

Are there any side effects?

Vitamin D supplementation is very unlikely to cause side effects when used as directed, even with high doses. Side effects that have been reported only very rarely include nausea, vomiting, poor appetite, constipation, weakness, weight loss and kidney damage.

Got questions about Vitamin D?

Why not contact us to ask them, and learn more about Vitamin D?


Custom hormone replacement therapy

What is Hormone Replacement Therapy (HRT)?

A woman’s oestrogen (or estrogen) and progesterone levels rise and fall with her menstrual cycle (peaking before and after ovulation, respectively) and levels of both hormones increase markedly during pregnancy.

MenopauseAt menopause, a woman’s oestrogen and progesterone levels fall, leading to symptoms such as:

  • hot flashes (or flushes),
  • night sweats,
  • emotional lability and/or irritability,
  • poor concentration,
  • sleep disturbances,
  • vaginal dryness,
  • urinary incontinence,
  • chills,
  • dizziness, and
  • fatigue.

Women who experience an early menopause (younger than about 45 years of age) may have increased risks of mortality and certain diseases compared with those who experience it at an older age.

Menopausal and post-menopausal women may be prescribed oestrogens (with or without progesterone) to boost their hormone levels and relieve symptoms. Such hormone replacement therapy (or HRT) also prevents osteoporosis and is thought to decrease the disease risks associated with early menopause.

Types of HRT

There are many forms of HRT, differing in the source of the hormones used (synthetic, natural, or conjugated equine), in whether or not a progestin is included, and in how the hormones are delivered – orally, injected, across the skin, absorbed from the mouth, or transvaginally.

This array of therapies complicate how one interprets the available studies on the benefits and risks of HRT. It is difficult, for example, to extrapolate regarding the safety of physiological human hormone supplementation when the majority of large studies have used synthetic or conjugated equine oestrogens and/or synthetic progestins (e.g., levonorgestrel or medroxyprogesterone acetate). The route of administration may also influence the risks of HRT, as dose forms that transfer oestrogens across the skin, mouth or vagina avoid oestrogenic overload effects on the liver (which may, for example, lead to an increased risk of abnormal blood clots).

The consensus medical opinion is that when delivered appropriately, HRT’s benefits exceed its risks.

Bioidentical HRT

Recently there has been interest in so-called “bioidentical” HRT, using only the chemical forms of hormones normally found in the human body, as these forms should have fewer undesirable side effects compared with synthetic or conjugated forms.

Another recent development in HRT is in custom-made bioidentical HRT: the supplementation of the range of biological oestrogens and progesterone as needed, with continual blood level monitoring supervised by a doctor, to maintain a woman’s measured hormone levels within the “normal” (or pre-menopausal) range. Some custom HRT combinations for women may also include the combination of an androgen (e.g., DHEA or testosterone), which may help with mood or libido.

Bioidentical HRT is delivered better and is more tolerable than many commercially-available HRT preparations. However it is important to maintain supply from a single supplier, since variations in product formulation between manufacturers or compounding practices may influence the dose of hormone received by the body.

Custom-made bioidentical HRT products

Topi-CLICK

Topi-CLICK metered dose cream applicators

Custom-made bioidentical HRT usually consists of one or more normal physiological human hormones in a combination to suit your body, including:

  • Oestrogens (oestradiol, oestriol, oestrone), often prescribed as Bi-est or Tri-est
  • Progesterone
  • Pregnenolone
  • Dihydroepiandrosterone (DHEA) and 7-keto DHEA
  • Testosterone

These hormones may be taken or applied in a range of of dose forms including capsules, troches, creams, gels and pessaries. Creams and gels may be dispensed in metered applicators to ensure accurate dosing.

Everyone’s hormones are unique. By working closely with your doctor, your HRT can be as optimised and individualised as it should be.

Please contact us for further information.


Melatonin

Melatonin - a regulator of day/night rhythms

Melatonin – a regulator of day/night rhythms

Melatonin is an endogenously produced hormone that is present in animals, plants and microbes. In mammals, melatonin is secreted by the pineal gland in the brain. Initially melatonin was discovered as the regulator of circadian rhythm and sleep, however its uses and roles within the body have been shown to go far beyond this.

What causes melatonin deficiency?

Numerous causes have been implicated in the deficiency of melatonin:

  • Disruption to regular sleep patterns (e.g. shift work, late nights, jet lag)
  • Drugs (e.g. alcohol, antidepressants (SSRI’s), anti-inflammatories)
  • Exposure to light (e.g. computers, tablets1, fluorescent lights2)
  • Age: Melatonin peaks in early childhood and decreases for the rest of life
  • Genetics: differences in pineal gland activity

Uses of melatonin

Sleep

  • Insomnia in older adults: Melatonin levels are lower in older people. Melatonin supplementation has been shown to shorten the duration of time it takes for older people to fall asleep and also improve the quality of sleep3.
  • Children: Children with conditions such as autism4, ADHD, visual impairment, epilepsy, psychiatric disorders or genetic predisposition to sleep disturbances have been shown to benefit from melatonin supplementation.
  • Jet lag/Shift work: Melatonin is useful in re-establishing a regular circadian rhythm.

Cancer

  • One meta-analysis found a 34% risk reduction in death for patients being supplemented with melatonin in conjunction with traditional treatments or alone5.
  • Other studies have found that melatonin in conjunction with chemotherapy for breast cancer enhanced the effectiveness of chemotherapy6,7,8.
  • Similar results have been found in patients being treated for solid tumours of the lung, chest, digestive tract and neck9. Furthermore, the use of melatonin in these patients seemingly led to lower incidence of side effects, reduction in anxiety and an increased survival rate.

Anti-Ageing

  • Melatonin is a powerful antioxidant and can neutralize oxidative stress and delay the ageing process.

Headaches

  • There are growing reports of the effectiveness of melatonin in preventing migraines, cluster headaches and tension headaches.

Sexual Function

  • As a powerful antioxidant, it has been theorized that melatonin may reduce the degeneration of blood vessels associated with sexual potency.
  • Melatonin appears to restore libido-enhancing sex hormones to their peak levels.

Other Promising Uses

  • Obesity: melatonin may reduce high levels of blood cortisol which has been linked to obesity.
  • Gall bladder stones
  • Protection from radiation
  • Irritable Bowel Syndrome: melatonin receptors are found throughout the gastrointestinal tract.

Taking melatonin

A prescription is required for any supply of melatonin in Australia.

Melatonin may be taken as capsules, troches, suspensions, and drops. A doctor may prescribe a slow-release or immediate-release formulation, depending on how an individual responds to treatment.

If you would like to learn more about melatonin don’t hesitate to call.

References

  1. Wood B, Rea MS, Plitnick B. Light level and duration of exposure determine the impact of self-luminous tablets on melatonin suppression. Appl Ergon.. 2013 Mar;44(2):237-40
  2. Gooley J, Chamberlain K, Smith K, Khalsa SB, Rajarathnam SMW, Zeitzer JM, Lockley SW. Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. J Clin Endocrinol Metab. 2011 Mar; 96(3): E463-E472
  3. Olde Rikkert MG, Rigaud AS. Melatonin in elderly patients with insomnia. A systematic review. Z Gerontol Geriatr. 2001 Dec;34(6):491-7
  4. Melke J et al. Abnormal melatonin synthesis in autism spectrum disorders. Mol Psychiatry 2008 Jan;13(1): 90-98
  5. Mills E, Wu P, Seely D, Guyatt G. Melatonin in the treatment of cancer: a systematic review of randomized controlled trials and meta-analysis. J Pineal Res. 2005 Nov;39(4):360-6
  6. Lissoni P, Barni S, Meregalli S, et al. Modulation of cancer endocrine therapy by melatonin: a phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progressing under tamoxifen alone. Br J Cancer. 1995 Apr:71(4):854-6
  7. Cos S, et al. Estrogen-signaling pathway: a link between breast cancer and melatonin oncostatic actions. Cancer Detect Prev. 2006; 30(2): 118-28
  8. Sanchez-Barcelo EJ, et al. Melatonin-estrogen interactions in breast cancer. J Pineal Res. 2005 May:38(4): 217-22.
  9. Lissoni P, et al. Decreased toxicity and increased efficacy of cancer chemotherapy using pineal hormone melatonin in metastatic solid tumour patients with poor clinical status. Eur J Cancer. 1999 Nov:35(12)1688-92