ChiroCredit.com/OnlineCE.com Presents: Intro To Hormones 102

Salivary Hormone TestingPart 3

Nutrition for Hormonal Supportby

Ronald Steriti, ND, PhD

© 2008

Hormonal Support

• In this section, we will review herbs and nutrition that may be beneficial for hormonal support.

Phytoestrogens

• Phytoestrogens are plants (phyto) that contain estrogen-like compounds.

• They have a weak estrogenic effect• By competitive inhibition (with “real”

estrogen), they also have an anti-estrogenic effect

• Desmawati, D and D Sulastri (2019), ‘Phytoestrogens and Their Health Effect.’, Open Access Maced J Med Sci, 7 (3), 495-99. PubMed: 30834024

Black Cohosh• Cimicifuga is useful for dysmenorrhea, delayed or

irregular menses, PMS, and hot flashes• Contraindications

– avoid in first trimester unless threatened miscarriage or premature

– large doses may cause vertigo, impaired vision, nausea/vomiting, headache

Ulbricht, C and RC Windsor (2015), ‘An Evidence-Based Systematic Review of Black cohosh (Cimicifuga racemosa, Actaea racemosa) by the Natural Standard Research Collaboration.’, J Diet Suppl, 12 (3), 265-358. PubMed: 25153652

Kligler, B (2003), ‘Black cohosh.’, Am Fam Physician, 68 (1), 114-16. PubMed: 12887117

Formononetin

• Cimicifuga racemosa (Black Cohosh) is a phytoestrogen that contains formononetin, which binds to estrogen receptors inducing an estrogen-like activity in the body.

• Morito, K, et al. (2002), ‘Interaction of phytoestrogens with estrogen receptors alpha and beta (II).’, Biol Pharm Bull, 25 (1), 48-52. PubMed: 11824555

Black Cohosh Efficacy

• There are many studies and articles on the use of Black cohosh for menopause and hot flashes

• Some are negative and some are positive.• The most promising results use the standardized

isopropanolic extract (Remifemin) • Negative studies usually show an effect with both

placebo and Black Cohosh • Borrelli, F. and E. Ernst (2008). "Black cohosh (Cimicifuga racemosa) for menopausal symptoms: A systematic

review of its efficacy." Pharmacol Res 58(1): 8-14.• Loprinzi, C. L., D. L. Barton, et al. (2008). "Mayo Clinic and North Central Cancer Treatment Group hot flash

studies: a 20-year experience." Menopause 15(4 Pt 1): 655-60.

Black Cohosh Safety

• Adverse symptoms have been rare (5.4%), mild and reversible. Most include gastrointestinal upsets, rashes, headaches, dizziness and mastalgia.

• In 2008, the Dietary Supplement Information Expert Committee determined that black cohosh products should be labeled to include a cautionary statement.

• Mahady, G. B., T. Low Dog, et al. (2008). "United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity." Menopause 15(4 Pt 1): 628-38.

• Kanadys, W. M., B. Leszczynska-Gorzelak, et al. (2008). "[Efficacy and safety of Black cohosh (Actaea/Cimicifugaracemosa) in the treatment of vasomotor symptoms--review of clinical trials]." Ginekol Pol 79(4): 287-96.

Red Clover

• Red clover has been a valued medicine since ancient times and was particularly valued for treating respiratory problems, colds, flues and infections in the 19th century.

• Red clover is recognized as a detoxification herb or "blood cleanser".

• Luís, Â, F Domingues, and L Pereira (2018), ‘Effects of red clover on perimenopausal and postmenopausal women’s blood lipid profile: A meta-analysis.’, Climacteric, 21 (5), 446-53. PubMed: 30269660

Red Clover

• Trifolium pratence (Red clover) contains isoflavones, which have a high affinity to estrogen receptor alpha and beta, progesterone receptor and androgen receptor.

• Red clover contains phytoestrogens: genistein, daidzein, formononetin and biochanin-A

• Beck, V., U. Rohr, and A. Jungbauer (2005), ‘Phytoestrogens derived from red clover: an alternative to estrogen replacement therapy?’, J Steroid Biochem Mol Biol, 94 (5), 499-518. PubMed: 15876415

• Lambert, MNT, et al. (2017), ‘Combined Red Clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms.’, PLoS One, 12 (6), e0176590. PubMed: 28591133

Dong Quai• Angelica sinensis (Dong quai) is a popular plant in

Chinese medicine used primarily for health conditions in women. Dong Quai has been called "female ginseng”

• Dong Quai balances estrogen activity and tonifies the uterus.

• It is useful for irregular menses, amenorrhea, dysmenorrhea, menopause, and hot flashes

• (2004). "Monograph. Angelica sinensis." Altern Med Rev 9(4): 429-33.

Dong Quai

• Angelica contains coumarins, which thin the blood; and ferulic acid, which inhibits platelet aggregration, and stimulates B and T cells.

• Cautions:– Dong quai may worsen diarrhea– Dong quai contains photoreactive substances,

avoid excess sun exposure

Vitex agnus castus• Vitex agnus castus (Chaste tree) helps regulate

hormones• Vitex is useful for hypermenorrhea, oligomenorrhea,

menorrhagia, dysmenorrhea, PMS, anovulation, infertility, and hyperprolactinemia

• Vitex must be taken over several months to show results

• Wuttke, W., H. Jarry, et al. (2003). "Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications." Phytomedicine10(4): 348-57.

• Roemheld-Hamm, B. (2005). "Chasteberry." Am Fam Physician 72(5): 821-4.

Vitex

• Vitex agnus castus (Chaste Tree) acts on the pituitary to increase LH production and inhibit FSH release, which stimulates progesterone secretion during the luteal phase and decreases prolactin levels.

• Nasri, S, et al. (2007), ‘The effects of Vitex agnus castus extract and its interaction with dopaminergic system on LH and testosterone in male mice.’, Pak J Biol Sci, 10 (14), 2300-7. PubMed: 19070148

VAC for PMS/PMDD • A systematic review of randomized

controlled trials found that VAC extract is a safe and efficacious alternative to be considered for the treatment of PMS/PMDD symptoms.

• Cerqueira, RO, et al. (2017), ‘Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review.’, Arch Womens Ment Health, 20 (6), 713-19. PubMed: 29063202

Spearmint

• One study found that after treatment with spearmint teas, there was a significant decrease in free testosterone and increase in LH, FSH and estradiol.

• Spearmint tea may be an alternative to anti-androgenic treatment for mild hirsutism.

• Akdogan, M., M. N. Tamer, et al. (2007). "Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism." Phytother Res 21(5): 444-7.

Saw palmetto

• Saw palmetto (Serenoa repens) is useful for benign prostatic hypertrophy (BPH), infertility (in men) and erectile dysfunction

• Cannarella, R, et al. (2019), ‘Non-hormonal treatment for male infertility: the potential role of Serenoa repens, selenium and lycopene.’, Eur Rev Med Pharmacol Sci, 23 (7), 3112-20. PubMed: 31002161

• Tacklind, J, et al. (2012), ‘Serenoa repens for benign prostatic hyperplasia.’, Cochrane Database Syst Rev, 12 CD001423. PubMed: 23235581

• Edwards, JL (2008), ‘Diagnosis and management of benign prostatic hyperplasia.’, Am Fam Physician, 77 (10), 1403-10. PubMed: 18533373

Saw palmetto and 5AR

• Saw palmetto contains liposterics, which inhibit 5-alpha-reductase & 3-ketosteroid reductase

• 5-alpha-reductase is an enzyme that converts testosterone into dihydro-testosterone

• Buonocore, D, et al. (2018), ‘Serenoa repens extracts: In vitro study of the 5α-reductase activity in a co-culture model for Benign Prostatic Hyperplasia.’, Arch Ital Urol Androl, 90 (3), 199-202. PubMed: 30362688

Hormone Metabolism

Zinc

• The human prostate gland contains extremely high zinc levels; which is due to the specialized zinc-accumulating acinar epithelial of the peripheral zone.

• RDA - 15 mg, Optimal - 30-50 mg a day• Sources: oysters!• Toxicity

– high doses often cause stomach upset and nausea– long term usage can induce a copper deficiency

Costello, LC and RB Franklin (2016), ‘A comprehensive review of the role of zinc in normal prostate function and metabolism; and its implications in prostate cancer.’, Arch Biochem Biophys, 611 100-12. PubMed: 27132038

The Zinc Tally Test

Put 1 tsp. Liquid zinc in the mouth and hold it for 1 minute. 1. No specific taste is noticed, even after 10 seconds2. A “dry”, “mineral”, or “fuzzy” taste is noticed after a few

seconds.3. A definite unpleasant taste is noticed immediately and

intensifies.4. A strong unpleasant taste is noted immediately. The subject

grimaces.Responses of 1 or 2 indicate the need for zinc.

Forsleff, L, et al. (1999), ‘Evidence of functional zinc deficiency in Parkinson’s disease.’, J Altern Complement Med, 5 (1), 57-64. PubMed: 10100031

Pygeum africanum

• Traditional African healers use Pygeum africanum (African plum) bark to treat bladder and urination disorders.

• It is particularly helpful for symptoms associated with benign prostatic hypertrophy (BPH).

• Positive research led to its common use in Europe for BPH.

• Salinas-Casado, J, et al. (2019), ‘Review of the experience and evidence of Pygeum africanum in urological practice.’, Actas Urol Esp, PubMed: 31627963

• Edgar, AD, et al. (2007), ‘A critical review of the pharmacology of the plant extract of Pygeum africanum in the treatment of LUTS.’, Neurourol Urodyn, 26 (4), 458-63. PubMed: 17397059

Beta-Sitosterol

• Several studies show that beta-sitosterol improves prostate function.

• A meta-analysis published in Cochrane Database of Systematic Reviews concluded that the evidence suggests non-glucosidic beta-sitosterols improve urinary symptoms and flow measures.

• Awad, A.B. and C.S. Fink, Phytosterols as anticancer dietary components: evidence and mechanism of action. J Nutr, 2000. 130(9): p. 2127-30.

• Bradford, P.G. and A.B. Awad, Phytosterols as anticancer compounds. Mol Nutr Food Res, 2007. 51(2): p. 161-70.• Wilt, T., et al., Beta-sitosterols for benign prostatic hyperplasia. Cochrane Database Syst Rev, 2000(2): p. CD001043.

Licorice

• The word licorice (Glycyrrhiza glabra) is derived from the Ancient Greek words for 'sweet root’.

• Glycyrrhizin is more than 50 times as sweet as sucrose (sugar).

• Anise seed is used in candy - it has a similar taste.

Licorice

• Licorice support the adrenal glands, which are a secondary producer of hormones.

• Licorice is commonly found in hormonal support formulas

• High blood pressure is the primary side effect of licorice.

• Sabbadin, C, et al. (2019), ‘Licorice: From Pseudohyperaldosteronism to Therapeutic Uses.’, Front Endocrinol (Lausanne), 10 484. PubMed: 31379750

• Yang, R, et al. (2015), ‘The Pharmacological Activities of Licorice.’, Planta Med, 81 (18), 1654-69. PubMed: 26366756

Diindolylmethane

• DIM (Diindolylmethane) is a phytonutrient found in broccoli, cauliflower, cabbage and brussels sprouts.

• DIM boosts good estrogens called 2-hydroxy estrogens and reduces bad estrogens, which are 16-hydroxy and 4-hydroxy estrones.

• Both forms of bad estrogen are carcinogens• Women with elevated levels of 16-hydroxy estrone

have a high rate of breast cancer. • Bradlow, H. L. (2008). "Review. Indole-3-carbinol as a chemoprotective agent in breast and prostate

cancer." In Vivo 22(4): 441-5.

DIM

• One study on human breast cancer cells found that DIM blocked estrogen receptors without the presence of estradiol and even inhibited the growth of estrogen-dependent cancer cells.

• Chang YC, Rilby J, Chang GH, Peng BC, Firestone G, Bjeldanes LF. Cytostatic and antiestrogenic effects of 2-(indol-3-ylmethyl)-3,3-diindolylmethane, a major in vivo product of dietary indole-3-carbinol. Biochem Pharmacol, 1999 Sep 1;58(5):825-34.

Genistein and Daidzein

• Genistein and daidzein are a soy-derived phytoestrogens (isoflavones)

• Genistein has been shown to bind to the same receptor sites as estrogen, which helps to maintain normal menstrual cycles and menopausal transitions.

• Thangavel, P, et al. (2019), ‘Genistein as Potential Therapeutic Candidate for Menopausal Symptoms and Other Related Diseases.’, Molecules, 24 (21), PubMed: 31671813

• Mayo, B, L Vázquez, and AB Flórez (2019), ‘Equol: A Bacterial Metabolite from The Daidzein Isoflavone and Its Presumed Beneficial Health Effects.’, Nutrients, 11 (9), PubMed: 31527435

Ipriflavone

• Ipriflavone is a soy derived isoflavone, also called 7-isopropoxyisoflavone.

• It is a synthetic derivative of the plant isoflavone, genistein.

• Ipriflavone is found naturally in bee propolis.

• Head, KA (1999), ‘Ipriflavone: an important bone-building isoflavone.’, Altern Med Rev, 4 (1), 10-22. PubMed: 9988779

Ipriflavone for Osteoporosis

• For many years, ipriflavone has been a prescription medication (Osteofix 200) for osteoporosis in Italy.

• Lymphocytopenia (decreased white blood cells) is listed as a contraindication on the Osteofix 200 label.

• Reginster, JY (1993), ‘Ipriflavone: pharmacological properties and usefulness in postmenopausal osteoporosis.’, Bone Miner, 23 (3), 223-32. PubMed: 8148667

• Rohatagi, S, et al. (1997), ‘Pharmacokinetics of ipriflavone and metabolites after oral administration of a corn-oil suspension relative to the Osteofix tablet.’, Am J Ther, 4 (7-8), 229-38. PubMed: 10423615

Calcium D-glucarate

• Calcium D-glucarate is the calcium salt of D-glucaric acid, a natural substance found in many fruits and vegetables.

• One of the key ways the body eliminates hormones is by attaching glucuronic acid to them in the liver and then excreting this complex in bile

• (2002), ‘Calcium-D-glucarate.’, Altern Med Rev, 7 (4), 336-39. PubMed: 12197785

Calcium D-glucarate

• Calcium D-glucarate inhibits beta-glucuronidase, an enzyme that breaks the bond between toxic chemicals and glucuronic acid.

• Elevated beta-glucuronidase activity is associated with increased risk for various cancers, particularly hormone-dependent cancers like breast, prostate, and colon cancers.

• Hanausek, M., Z. Walaszek, et al. (2003). "Detoxifying cancer causing agents to prevent cancer." IntegrCancer Ther 2(2): 139-44.

Vitamin E

• Vitamin E is useful for dysmenorrhea, menopause, PMS, and fibrocystic breast disease

• Natural forms include alpha, beta, gamma and delta tocopherol

• DL-alpha tocopherol is the synthetic form• Chamras, H., S. H. Barsky, et al. (2005). "Novel interactions of vitamin E and estrogen in breast cancer."

Nutr Cancer 52(1): 43-8.• Hartman, T. J., J. F. Dorgan, et al. (2001). "Effects of long-term alpha-tocopherol supplementation on

serum hormones in older men." Prostate 46(1): 33-8.• Hartman, T. J., J. F. Dorgan, et al. (1999). "Association between serum alpha-tocopherol and serum

androgens and estrogens in older men." Nutr Cancer 35(1): 10-5.

Detoxification

• Recall that all of the sex hormones are produced from cholesterol via the P450 enzyme system

• P450 is part of phase 1 detoxification (oxidation, reduction and degradation), which detoxifies alcohol, carbon tetrachloride, barbiturates, dioxin, and paint fumes

Detoxification

• Hormonal problems sometimes coexist with hepatic detoxification issues

• Consider detoxification in cases that do not respond to supplementation, or if there is a history of headaches, sensitivity to coffee and/or gas fumes.

Summary

• Phytoestrogens– Cimicifuga racemosa (Black Cohosh)– Trifolium pratence (Red clover)– Genestein and Dadzein (from soy)– Beta-Sitosterol

• Beta-glucuronidase inhibitors– Calcium D-glucarate

Summary, continued

• Herbs– Vitex agnus castus (Chaste tree berry) – Pygeum africanum– Spearmint

• Nutrition– Vitamin E– Ipriflavone for bone density

Summary, continued

• 5-alpha-reductase converts testosterone into dihydro-testosterone (DHT)

• Saw palmetto inhibits 5 alpha reducase• Zinc status can be tested by drinking it (The

Zinc Tally Test)

Summary, continued

• Hormones and toxic elements are cleared from the body in the lever by a process called detoxification

• It is typical for young (and old) adults to party excessively causing toxins to build up

• Detoxification may be indicated in cases of hormonal imbalance.