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Hormone Balancing For Immune Support The word hormone is derived from the Greek word “to excite.” Though hormones are released in very small amounts, they can have both wide-ranging and powerful effects. They influence sex drive, energy level, immune function, mood, metabolic rate, sleep, and appetite. Within ten years, I predict the use of natural hormone replacement therapy in men and women will play a very important role in standard medical practice. (This does not include the practice of giving estrogen collected from the urine of female horses to women in menopause, the way the most frequently prescribed brand of estrogen, known as Premarin, is produced.) Endocrine glands secrete hormones in response to stimulatory signals from the brain. The pituitary/hypothalamus region of the brain monitors the blood and decides when to stimulate hormone secretion by individual glands such as the testes (testosterone), the adrenal glands (DHEA, cortisol, epinephrine), the pancreas (insulin), the ovaries (estrone, estrace, and estradiol), and the thyroid (thyroid hormone). If the brain is under a great deal of stress, the regulation of your endocrine gland’s hormone output by the brain can become disrupted. The endocrine system affects the immune system both directly and indirectly. Hormones such as DHEA (dehydroepiandrosterone) and thymic factors have been shown to directly mediate immune system functioning by stimulating lymphocytes and other white blood cells. In contrast, testosterone’s influence on mood, libido, and muscle mass has an indirect but significant effect on the immune system’s functioning. Many patients with chronic medical conditions, including HIV, Cancer, and Chronic Fatigue, experience a gradual decline in their quality of life which can extend over many years. Many of the symptoms associated with this decline are significantly influenced by hormones. Important Note: When measuring serum hormone levels, the “normal range”, as defined by the testing laboratory, is the average level found in the general population. This range is very large and includes people who feel sick and tired all the time, as well as those who are healthy and feel great. In my experience, the normal range for people with chronic medical conditions should be the hormone levels found in a 25 to 35 year old adult at their peak of health. This is what I define as the “optimal hormonal range for healing.” Hormones and Body Cell Mass As described in detail in my book “Healing HIV,” maintaining your body cell mass (muscle tissue) at 100% of ideal levels, can help to optimize the functioning of your immune system. Maintaining your testosterone level within the “optimal range “(in both men and women) can help ensure that these body composition goals are met. Some physicians never test their patient’s testosterone level. Others give all of their patients regular testosterone injections whether they need them or not. As always, the key to maintaining good health is finding the right balance for each individual patient’s situation. Hormones that build body cell mass are classified as steroids. This term refers to the physical structure of the molecule and not its function. Steroid hormones are essential to good health and exert a multitude of positive effects on the body. Estrogens soften the skin and stimulate the growth of the breasts. Androgens, such as testosterone, have masculinizing effects that promote hair growth, enlargement of the genitalia, and a deepening of the voice. Steroid hormones that increase muscle mass are termed anabolic steroids. Natural anabolic steroids, produced by both men and women for this purpose, include testosterone and DHEA. Many of my patients (both men and women) have benefited tremendously by supplementing with natural testosterone to elevate the level of this hormone in their blood to the optimal level for health. I define this level as the hormone level found in a 25 to 35 year old adult at their peak of health. This is the optimal level for increased energy and healing to occur! If you are experiencing progressive weight loss or a declining body cell mass do not hesitate to use one or more supplemental anabolic hormones as part of your treatment program. They can greatly enhance both the quality and quantity of your future years. However, I do not support supplementing anabolic hormones just for the sake of appearance or for building body cell mass above 100% of ideal levels. Testosterone Testosterone is the hormone responsible for the masculinizing and tissue-building changes which occur in male adolescents. These include the maturing of the genitalia and the development of secondary sexual characteristics such as hair growth. Women also produce testosterone, though only at about 10% of the level produced by men. Several studies have shown that testosterone levels are frequently decreased in people with fatigue and immune deficiencies. Research performed by Marc Hellerstein and colleagues at the University of California Berkeley has shown that the mean testosterone level of healthy, asymptomatic HIV(+) men is significantly lower than that of HIV-negative controls. His data suggest that sub-optimal testosterone production in HIV(+) males is an extremely common occurrence. One might postulate from this and other studies that early hormone supplementation to restore an optimal testosterone level might play an important role in an HIV(+) individual’s maintaining long term health and a high quality of life. Keeping your testosterone level in the optimal range is important for maintaining a healthful body cell mass as well as for preventing fatigue, depression, and diminished sex drive. As I previously stated, the optimal range for testosterone in HIV(+) men is not the same as the normal range commonly reported by most labs. The normal range for total testosterone in men is usually listed as 200-1000 ng/dl. The optimal range is 500-1000 ng/dl. This level is more effective at helping build and maintain body cell mass while still remaining within safe parameters. Finally, testing the free testosterone level, as opposed to the total testosterone level, is more expensive but also much more sensitive at picking up a borderline testosterone deficiency. It is more important when evaluating women patients to use the free testosterone test. Testosterone Delivery Systems Injectable Testosterone Injectable testosterone is commonly used to treat testosterone deficiency. The injectable form, usually injected deep into the gluteus muscle every two to three weeks, ameliorates the underlying testosterone deficiency but can initially cause very high levels of testosterone in the blood. An injection of intramuscular testosterone usually results in a peak level above the limit of normal for several days followed by a gradual decline during the next two weeks. This promotes an increased risk of side effects such as headaches, anxiety, insomnia, irritability, mood swings, aggressive behavior, muscle tension, and testicular atrophy (shrinkage). This pattern of testosterone release is different from the body’s normal testosterone release pattern which provides a fairly steady blood level throughout the day. That is why testosterone creams, applied once or twice daily, are currently my preferred testosterone delivery system. Testosterone Cream Natural testosterone can be mixed into a cream or gel so that it is absorbed shortly after rubbing it into the skin of the scrotum (in men) or the abdomen or thigh (in women). A compounding pharmacy with good quality standards is the best source for this type of application method. AndroGel, a testosterone gel made by the Unimed Pharmaceutical Company, cannot be applied directly to the scrotum and costs 5x as much as most compounded testosterone gels. In my practice I use Kronos Pharmacy (800-723-7455) and recommend concentrations from 1% to 20% to be applied 1- 2x per day depending on the particular individual’s needs. After 1-2 months of use, a repeat blood test is all that’s necessary to fine- tune the dosage so you can stay in the optimal range for healing. Testosterone preparations always require a prescription. By administering testosterone in this fashion, you can most closely approximate the normal way your body releases testosterone into the bloodstream. Testosterone Patches There are two forms of testosterone patches currently available. The scrotal testosterone patch (Testaderm) is applied daily in the morning to a clean, dry scrotum which has been trimmed of hair. The Testaderm patch effectively increases the testosterone level into the normal range in most individuals yet it is often found uncomfortable to wear every day and sometimes falls off. A second type of testosterone patch can be applied to the upper body usually on the back or anterior abdomen. At the present time, testosterone body patches are made by two companies. Alza Pharmaceuticals makes Testaderm TTS, which stands for testosterone transdermal system, and Smith-Kline Pharmaceuticals makes Androderm. Both patches are similar in their effect but the Testaderm TTS patch is thinner, less bulky, and not as often associated with skin irritation. If skin irritation does occur, the application of triamcinalone 0.1% cream (available by prescription) underneath the patch can eliminate this side effect in most cases. Hormone Balancing For Immune System Support – DHEA (Dehydroepiandrosterone) In short, DHEA protects your body from the physical effects of stress. Too little DHEA can promote autoimmune diseases, chronic fatigue, heart disease, and depression and more doctors should be testing its level in their patients and supplementing it when they find it to be low. First of all, let me state straight out that I do not agree that DHEA should be sold as an over-the-counter supplement. Hormones are very potent substances that should be finetuned and balanced with the use of state of the art blood testing. Only a physician can order these tests and monitor your hormone needs at regular intervals. Many people take DHEA who don’t need it, many people take too much of it when they only need a little, and many people take less than what they truly need. DHEA can be thought of as your body’s protector from stress. It sooths and buffers your brain, nervous system, immune system and cardiovascular system from inflammation. After years of living with cancer, HIV infection or chronic psychological stress, your DHEA level can fall to a tenth or less of its optimal level. DHEA deficiency is also commonly seen in autoimmune disorders such as rheumatoid arthritis and lupus. As I mentioned in my last E-newsletter, there is a BIG difference between the “normal range” for hormones as reported by most laboratories and the “optimal range for healing” which I define as the upper limit of the laboratory’s stated normal range. This is especially true for DHEA. First of all, it is important that you monitor your DHEA level with a DHEA-Sulfate test. It is cheaper and far more accurate than a plain DHEA blood test. Just make sure DHEA-Sulfate is written on your lab slip. If your doctor forgets to put Sulfate down next to DHEA, feel free to write it in! Next, the optimal level of DHEA to have in your system is the amount that you had when you were in your late twenties and early thirties. This is the level that supports your body for optimal health. For men, this level is 300-600 ug/dl and for women it is 100- 300 ug/dl on the DHEA-Sulfate test. Depending on your starting point, 10-50 mg for women and 50-200 mg for men is the most common dosage that I find myself prescribing. Remember, do not self-prescribe DHEA! Clinical Experience Since 1994 I have prescribed DHEA to thousands of patients in order to bring their levels into the optimal range. By keeping DHEA in this range, many of my patients have regained a healthfully functioning immune system. Patients feel better, have more energy, and appear to be less susceptible to the negative effects of stress. In addition to using healthful nutrition, vitamin therapy, and aggressive medical intervention when necessary, DHEA supplementation has helped the vast majority of my patients remain healthy and stable for many, many years. Common Sense and DHEA There are no human hormones that, in an effort by physicians to restore normal homeostatic balance to the body, are not supplemented if found to be below normal levels by a blood test. Insulin, estrogen, testosterone, growth hormone, cortisol, and thyroid hormone are all supplemented if their levels are found to be low. Just because we haven’t fully documented all of the subtle beneficial effects of DHEA, or found that a deficiency of it causes an acute short-term problem, we assume that supplementation is not necessary. How arrogant and shortsighted we physicians can be! Because the beneficial effects of DHEA are subtle, studies to identify its benefit should look for a lessening of symptoms, a maintenance of healthful weight and muscle mass, and an improvement in quality of life over the long term. They should also look for improved trends in disease progression and mortality as markers of its overall effect. These studies should utilize the dosage necessary to optimize blood levels, not pick an arbitrary dosage that assumes everyone’s need for DHEA is the same. For those readers who would like to review a list of research studies investigating the role of DHEA supplementation in the treatment of HIV disease, please click on the following link: http://www.jonkaiser.com/research/studiesdhea.html Finally, it is important to realize that the level of hormones in the body need to be carefully balanced for optimal energy, vitality, and immune function to exist. Testosterone, DHEA, and thyroid hormone make up an important triad of hormones that, when correctly balanced and monitored, can help you achieve a state of optimal energy and overall health. continued next page: Hormone Balancing For Immune System –Thyroid |
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