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Assessment and Treatment of Hormonal Balance

Hormonal Balance:
The issues related to hormonal therapies are complex. The conventional medicine point of view holds that there are specific diseases, established by specific laboratory tests that require specific treatments. There is not much room to maneuver. Any disagreement from this point of view places the individual at risk for criticism, professional censure and potential harassment from medical societies, and state medical boards. There is another point of view, however. I should say that there are many points of view that diverge from the conventional medical model. When trying to navigate through the mass of information, I try to establish some points of reference.

  1. In biology there is a continuum from optimal function to pathologic function and overt disease.
  2. Conventional medicine is concerned about overt disease. It considers a patients perception of dysfunction that occurs without corroborating laboratory or physical findings as psychological and “not of the body”. This perception persists despite a mountain of scientific evidence to the contrary.
  3. Symptoms related to hormonal imbalance, inadequacy and or excess could occur even when the laboratory tests that conventional medicine uses are in a normal range.
  4. Physiologic hormonal supplementation can be safe and effective in relieving symptoms and improving health. This approach emphasizes the use of the lowest dose of a hormone supplement to achieve benefit. Hormone supplementation is safest and most effective when low doses of appropriate hormones are used to achieve an improvement in the person’s experience of good health. A health care practitioner must supervise this process.
  5. The use of hormonal supplementation is only part of the process of optimizing endocrine function for an individual. We must pay attention to diet, exercise, and the individuals’ social context. We greatly underestimate the degree to which these issues affect optimal endocrine function. In this context we can look at macronutrient nutriture (calories, proteins, carbohydrate, fat and fiber) as well as micronutrient nutriture (vitamins, minerals, bioflavanoids and phytosterols). An exciting new area is the effect of dietary fats on endocrine function. Exercise has a profound effect on hormonal balance. The stressors we live with have a profound effect on hormonal balance. We must continue to pay attention to the Functional Medicine principles of optimizing bowel health, supporting detoxification processes, reducing toxic exposures, and reducing inflammatory/oxidative stress.
  6. Functional hormonal therapy often works best when multiple hormones are given in a balanced manner.
  7. Each person will have a unique need and a unique reaction to therapy. One size does not fit all.
  8. This type of therapy is a process. It requires the cooperation of the patient and treating physician. It is not simple and it takes time to achieve good results.
  9. This approach is not static. Its evolution is based on clinical experiences with patients and the evolution of the medical literature.

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