Ageless: The Naked Truth About Bioidentical Hormones (38 page)

PM:
Definitely. The women I see are largely professionals because my practice is located in Silicon Valley; so not only is this an issue of quality of life, feeling good, and feeling rejuvenated, but it’s also often an issue of being competitive and youthful. These are women who, even though they might be sixty-five or seventy, want to hold on to their job. They don’t want to be told they can’t work any longer. They want to look, act, and feel younger and stay mentally sharp. What we do here at the Longevity Center is prolong or restore their careers, along with quality of life.

Some of them have been on synthetic hormones, and they tell me, “Listen, I still want to be on hormones, but I want something safer. I
want something that is individualized.” So I put them on bioidentical hormone replacement, and it gratifies me to see these women who look and feel like they are fifty-five or fifty-eight, even though they may be seventy-two. They have a kind of spirit, an excitement; they have that look in their eyes. Their skin quality is improved. It has been a real joy for me knowing that I can help this expanded population of women.

SS:
What is the number one complaint you hear among your patients?

PM:
They mainly say, “I don’t feel right. I want to feel better than this.”

SS:
What do you do for them?

PM:
I spend at least an hour doing a thorough history. I give them their physical and go through the usual formalities of making sure I haven’t missed anything. What things have you tried? What worked? What didn’t work?

Then we sit down and talk about the general approach of what I do, and I try to figure out by clues and questions and certain repetitive patterns that I see over time. Does this sound like a thyroid problem, or does this sound like an estrogen problem or a progesterone, or adrenal, or testosterone problem?

SS:
What I hear mostly from women is the loss of sex drive. Are you getting that complaint?

PM:
There is a myth in our society that when women get to their late forties and fifties, they are no longer interested in sex. But that is not true at all. I have patients say to me all the time, “Fix me up. I used to really enjoy myself. My partner and I were once little bunnies, but I’m finding I can’t enjoy it anymore.”

SS:
Hormonal loss takes away the “feeling.” It’s like being dead inside. What do you do for a woman who has lost her sex drive?

PM:
First, I ask her a series of questions: “Do you love your husband? Is he still attractive to you? Has he gotten fat? Do you two fight? Do you enjoy any time together? Do you turn off your cell phones?” When she responds, “Yes, I love my husband,” that’s when we can get to work. I need to explore whether hers is an estrogen,
testosterone, or progesterone problem and look at all of these levels and their relation to one another. So many women want me to put them on testosterone immediately, but I need to see how all of these hormones are related to one another to restore the correct balance.

The same is true with men. I have seen guys with really high testosterone levels, but they’re not interested in sex. Then I see other men with low testosterone, and they have a high libido. It’s not just about testosterone; it’s about ratios and balance.

SS:
What have you encountered lately relative to hormone replacement?

PM:
High cortisol is a huge issue in today’s world. People are so stressed out. I think 9/11 had a lot to do with it, in particular, and so has lifestyle in general. Elevated cortisol leads to adrenal burnout, and adrenal exhaustion takes away a person’s stamina and happiness.

When your adrenals are exhausted, you have no bodily reserves to deal with inner stress. Consequently, you get illnesses such as colds or bronchitis, or you experience psychological stress that shows up as depression or personal stress, at home or on the job. What happens then is you start to eat a lot more sugar.

SS:
What are we doing to ourselves in this country?

PM:
I would rephrase that question: What’s being done to us? I believe fear is being manufactured in this country—fear of outside forces, 9/11 fears. Over the past few years, I have seen the cortisol levels of my patients soar. People are spinning out of control from both the political climate and environmental problems. It also has to do with the type of lives we are leading; we are just doing too much. Cell phones, for example, are destroying people.

SS:
Because they are never by themselves?

PM:
Exactly. It seems as though if they’re not talking to someone, they get nervous. I see women in the supermarket line on their phones or a mother and daughter walking down the street who are both on their cell phones.

My advice to them would be: Pay attention to your life. Here you are with your loved one or your child, yet you are on this inanimate phone talking to someone in space. I do believe this constant in-touch
technology is really stressing people out—and it’s one of the main reasons chronic disease is on the rise. You know, the number one cause of breast cancer is stress. Frequently, it’s a combination of physical, social, and economic stress.

SS:
Isn’t stress a result of hormonal imbalance?

PM:
It can be. Stress affects the thyroid and adrenals first. So if your thyroid is depressed, your immune defenses can be weakened, since your immune system is connected to your thyroid functioning. Now perhaps you’re a candidate for a disease.

Stress can lead to cancer, diabetes, and cardiovascular disease, to name just a few. But no one takes this seriously. Men think it’s fix-able. I tell them that stress not only will lead to serious illness or death, but along the way it’s also going to alienate you from your kids and your wife, and you could lose your sex drive, unless stress is managed.

SS:
So you deal with all of this from a mind/body/spirit connection?

PM:
My approach is a fully integrated program, with five steps. In the first step, I deal with metabolic issues, focusing on exercise, supplements, and a raw diet, if necessary. Many people have gastrointestinal problems, so I look into that initially, because resolving these problems sets the stage for hormones to work better.

The second step is hormonal modulation, but it’s not “here’s your prescription; have a nice life.” It doesn’t work that way. If a patient wants his or her hormones to work effectively, they must do some basic nutritional, exercise, and supplementation routines.

I deal with bioidentical hormones only—not just estrogen, progesterone, and testosterone, but also DHEA and thyroid.

The third stage is cognitive. Now that we’ve got your hormones working better, your mood is improved; I can start fine-tuning your cognitive abilities. This is where it gets really interesting. For example, how do we affect mood without using psychoactive drugs? How do we get the mind functioning to get you as mentally sharp as you can be?

SS:
How do you do this?

PM:
It boils down to the balance between dopamine (a brain chemical) and choline (a B vitamin), which are stimulating, and GABA and serotonin, two brain chemicals that are sedating. Most people need a
little more choline, along with a drug called Deprenyl, which is a brain enhancement agent, to get them sharper. I will ask my patient, “If you’re in a meeting with a lot of people and events to remember, are you able to keep on top of everything, or do you have trouble keeping up?” Their answer helps me to determine what needs strengthening.

SS:
We’ve gone through the first three steps of your program. What’s next?

PM:
The fourth step is stress reduction. At this point in the program, my patients are eating better, their hormone balance is better, their cognitive abilities are better, and their ability to withstand the vicissitudes of daily life is immensely improved. But they are really still in the eye of the hurricane. Everything is circling around them at 175 miles an hour, but in the eye it’s only 25 miles an hour. They haven’t yet reduced all their life demands, but they have improved their ability to cope with them.

Part of this step involves yoga and meditation; both are important ways to reduce stress. Yoga is also good for stretching because it keeps us limber. It loosens our ligaments and tendons, which thicken with age, and helps our bodies become more elastic. Beyond that, yoga teaches you to slow down and breathe.

SS:
And number five?

PM:
Step five is the mind/body/spirit connection and involves coming to grips with where you are in life. How do you relate to the universe and the people around you? What or who are you? What are you doing? Where are you going? For me, this is the most satisfying work I have ever done.

SS:
How great! If you could change anything, what would you change in the lives we are all living today?

PM:
I would like to see more people realize that you’ve got to take responsibility for your own life. It’s not someone else’s fault; it’s not someone else’s responsibility. The life you lead is up to you. We are all buffeted by things we can’t control, but the life you live is determined by you. You are in charge of your choices. You have to be motivated to make changes in your life that are positive and life-giving.

SS:
Thank you so much for this wonderful information.

DR. MILLER’S TOP FIVE ANTIAGING RECOMMENDATIONS

1. Loss of sex drive in a woman can be related to a decline in estrogen, testosterone, or progesterone. Your doctor should check your levels and restore the correct balance.

2. If you want your bioidentical hormones to work effectively, you must do some basic nutritional, exercise, and supplementation routines.

3. To enhance your brain function, talk to your doctor about supplementing with choline or a drug called Deprenyl.

4. Definitely consider yoga and meditation; both are important ways to reduce stress. Yoga is also good for stretching because it keeps us limber. It loosens our ligaments and tendons, which thicken with age, and helps our bodies become more elastic. Beyond that, yoga teaches you to slow down and breathe.

5. Take responsibility for your own life and your choices. We are all buffeted by things we can’t control, but the life you live is determined by you. You are in charge of your choices.

CHAPTER 19
D
R
. G
ORDON
R
EYNOLDS:
S
TRESS

Dr. Gordon Reynolds spent thirty years in obstetrics and gynecology and then returned to school to get a PhD in nutrition. His interests today lie in reproductive endocrinology, and he is a sought-after speaker on the lecture circuit. He is currently part of the faculty at the Green Valley Spa in Utah
.

SS:
Let’s talk about the effects of stress on aging.

GR:
We’ve accelerated our lives considerably. We’re in a state of constant compulsive thinking about making money, obtaining more things materially, and trying to do so many things—a state of turmoil that almost creates a collective disease. Stress is responsible for the majority of the processes we experience. Stress increases cortisol levels, which, in turn, can interfere with hormonal balance and inhibit thyroid function. In a postmenopausal woman or even in a premenopausal woman, usually the progesterone has already dropped out. Stress speeds up this process. In fact, 50 percent of women over thirty-five are no longer producing adequate progesterone. That may or may not influence testosterone or DHEA, but as soon as progesterone drops out, the rest of her hormones are now imbalanced.

SS:
You obviously feel that stress is a major factor in today’s world, and it interferes with our hormonal system. I require enormous amounts of estrogen to think straight, and I believe in mimicking normal physiology, meaning having a period. If we need estrogen
and progesterone in balance, or in the correct ratio, shouldn’t we try to achieve the same balance we had at our strongest and healthiest?

GR:
It depends upon the individual. If she requires more, then we replace more. But I differ with you in that I don’t demand that a period occur if all the criteria are met. However, if a woman wants a period, if it makes sense to her as it does to you, then we can make that happen with bioidentical hormone replacement.

The reason I feel so strongly about replacing hormones is that I didn’t start at sixty-four, I started much earlier. When I speak to a group, I say, “Let’s draw a line down the middle of the board, fifty on this side and fifty on the other. Let’s look at the things we did when we were younger and what your hormone balance was then.” I show how DHEA peaks at twenty-five and then fizzles out at 2 percent a year, then testosterone drops off, and then progesterone stops production.

Then we look at the other side, and I ask what we can learn in these next fifty years from what we garnered from the past. If you understand that your peak health was in your reproductive years, can we safely increase these hormones by keeping them in balance on the other side of the fence without problems? I say we can. It’s been shown. There have been enough studies by the antiaging society medical groups and enough published worldwide literature to say that this is not hazardous.

Twenty-five percent of all women go through menopause pretty well; another 25 percent have a terrible time; and 50 percent are just all over the board. Those who go through it well, without a lot of stress, are the ones who have a good nutrition and exercise program in place.

Interestingly, most women in third world countries don’t have a problem with menopause. It’s not even in their vocabulary. Most of them don’t have hot flashes or any of the typical symptoms. What’s the difference? Stress!