Bioidentical Hormone Balancing and Functional Medicine

Wow 🤩

Today, at the conference, I gave a different kind of talk than I usually do. It explored the connection between the science and the symbolism of mitochondria. I’ve been talking about eating the natural colors of whole foods for some time (“eating a rainbow”). 🌈 That rainbow I’m talking about has many layers of meaning; one goes deep into the mitochondria.

The sunlight that plants turn into energy through photosynthesis ultimately translates within our mitochondria into ATP and the production of reactive oxygen species, each with their own wavelengths and respective colors. Research studies measure this light emission as biophotons. The mitochondria are also very ancestrally tied into the maternal line, or the yin aspect of our being. They yoke us to the aspect of wielding nourishment.

We want the mitochondria to have the proper balance of darkness and light, and one of the ways it can safely stay in darkness, without the excessive light spray of reactive oxygen species, is through the amphiphilic antioxidant, melatonin, which is highly concentrated in the mitochondria. Melatonin can be made in the mitochondria, but also comes from the pineal gland in response to darkness to sync us up with circadian consciousness and the deeper rhythm that runs through life.

When you go deeper, you can’t help but see that the mitochondria is truly more than the “powerhouse” of the cell to give us ATP. It is our inner power, our qi, our life force threaded through each cell of our being. The more we have, the more we are vitalized.

Du J, Deng T, Cao B, Wang Z, Yang M, Han J. The application and trend of ultra-weak photon emission in biology and medicine. Front Chem. 2023;11:1140128. Published 2023 Feb 17. doi:10.3389/fchem.2023.1140128. CCBY

A'HO...

🌸 Join us at FORGE for an enlightening evening with Dr. Ghazala Aziz-Scott, the remarkable women’s health doctor who “fixed” our founder Amanda Mansell!

This week’s groundbreaking news: employers could face lawsuits for disability discrimination if they fail to accommodate menopausal women. This ruling, a first from the Quality and Human Rights Commission, underscores the urgent need for awareness and support.

“During FORGE’s refurbishment, I didn’t realise I was perimenopausal—I simply thought it was stress from setting up a new business! 6-months in, I was hit hard by menopause—sleepless nights, relentless night sweats, and overwhelming emotions. I couldn’t even get a GP appointment. Then I remembered Ghazala, a client specialising in women’s health. She offered a free consultation and said “Don’t worry darling I will fix you!” Within a few weeks she had. I felt like me again thanks to her expertise and personalised care”. -AMANDA MANSELL

It’s time to break the silence surrounding menopause. Join us for an open and frank evening with Dr. Ghazala Aziz-Scott. She’ll cover Perimenopause, menopause, the truth about hormone replacement, other midlife health considerations, personalised medicine, and hormone balancing nutrition.

📅 Date: Tue 26 Mar
⏰ Time: 6pm-8pm
💰 Price: £5. Book via link in our bio.
📍 Location: FORGE, 59 Leather Lane, London EC1N 7TJ

Spaces are limited, so book to secure your spot! Refreshments will be provided

, Partner at The Marion Cluck Clinic, brings unparalleled expertise in women’s health. With a background in Medicine from Cambridge University, a Masters in Neuroscience, Medical Ethics, and Law, and extensive training in women’s health including the DRCOG and DFFP, her credentials are impeccable.

Metaphorically, how could cells be conceived as miniature “people”? - Bruce H. Lipton, PhD The Universe is built upon fractal geometry.

Last week I ran a video highlighting the importance of all the bodily functions & systems that benefit from the natural production of oestrogens & progesterone - as a result of having regular menstrual cycles / ovulating.

I promised to explain the impact natural oestrogen o***y production has on the brain, and does the oestrogen in the contraceptive pill offer the same benefits…. Read on 🧐

Ovarian oestrogen has a profound impact upon the brain, esp in adolescence:
1️⃣ Affecting regional grey matter volumes; the place where the processing of sensation, perception, voluntary movement, learning, speech & cognition takes place
2️⃣ Also oestrogen increases neural connectivity associated with psychosexual and other behavioural functions

In adulthood these hormones (oestrogen and progesterone) continue to shape the brain by modulating areas involved in cognitive & emotional processing, and are implicated in mood & anxiety disorders.

Enter synthetic hormones found in hormone contraception. The “oestrogens” & “progesterone” in these formulations contain drugs with similar names - progestins & ethinylestradiol BUT they are NOT THE SAME. We have to shout this from the rooftops 📢 as this misconception is failing women from adolescence to perimenopause (tune in next week for my perimenopause discussion).

A Danish study back in 2016 by Skovlund found a correlation between the use of Hormone Contraception and a subsequent first diagnosis of depression and the use of antidepressants. The increased risk of these adverse outcomes was noted to be the highest in adolescent women.

Fast forward to May 2023 a population-based cohort study based on data from 264,557 women from the UK concluded “...the use of OCs, particularly during the first 2 years, increases the risk of depression. Additionally, OC use during adolescence might increase the risk of depression later in life. Physicians and patients should be aware of this potential risk when considering OCs & individualised risk–benefit assessments should be conducted.”

Are we REALLY still here, blindly prescribing drugs without explaining risks to young women, parents / carers!

Such important information 🙏🏻

Hormonal contraception is prescribed to adolescents for a myriad of indications from pregnancy prevention to treatment for acne or painful periods. The use with teen girls has been shown to have both seriously negative impacts on their mental health & bone health.

Today, I want to focus on bone health. As the image shows, teen years are a critical window for acquiring "peak bone strength" - the time of optimal skeletal development that will prevent fractures in late adulthood by providing bone reserve. Sounds important, right 🤔 The age at which peak bone mass is achieved varies for the hip, spine and other sites, but 90–95% occurs by the age of 21.

S*x hormones aka oestrogen, progesterone, testosterone made by the ovaries (predominately just to keep things simple) & growth hormones play a major role in achieving peak bone mass. Alterations in production of these hormones during this critical window can have lasting effects on peak bone strength. And the drugs in birth control - aka The pill ARE NOT the same structure nor do they provide any of the benefits that our naturally produced oestrogen & progesterone provide.

Studies indicate that Combined Oral Contraception use can compromise bone mineral acquisition in teens, esp if taken in the first 3 years post their first period.

Does this matter? Hell yes, missing the opportunity to attain peak bone mass, we have a generation of teens at risk of developing stress fractures, not to mention that oestrogen (naturally produced “oestriadiol” NOT ethinyl estradiol as a drug like the pill) also plays a role in the development of the microarchitecture that allows bone to withstand pressure & be flexible.

Prescribers of birth control SHOULD be transparent & counsel teens about the impact of hormonal contraception on their lifetime bone health. As states in her brilliant book Hormones Health & Human potential - “a 10% decrease in peak bone mass is predicted to bring forward by 13 YEARS the development of osteoporosis.”

Remenber - I'm hosting a Best of Health webinar next week The Bones of The Matter to provide all women with the info you need to protect your bones for life! Link in bio

📣Exciting news! Due to the success of last years Hormone Conference we are bringing you the second “The Ultimate Hormones Conference 2023”

❓When: Thursday 30th November
❓Where: Online virtual event

This will be a deep dive into hormonal systems focusing on bringing you the latest knowledge and research, enabling practitioners to gain empowering strategies for Endometriosis, HPA Axis & Metabolic Balance.

We will be bringing you both live and on demand talks from renowned experts in the field of hormones.

Live presentations from Dr. Carrie Jones, Dr. Ghazala Aziz Scott and Patrick Holford. On demand sessions from Dr. Golnoush Golshirazi, Dr Sally Moorcroft, Zita West and Jo Gamble.

Find out more in our link in Bio [Nadia link this to the website: https://registration.hormonesconference.com/the-ultimate-hormones-conference] 🔗 and book your ticket today. ⚡Early bird discount £40 until 31st October and from Nov 1st £50.

👉Don't miss out on this opportunity to learn from the best in the field of hormones. Register now!
carriejones .uk

Sugar

I’ve heard numerous accounts of young women being offered oral or injection contraception as the solution, for many situations other than contraception; menstrual pain, irregular menstruation, acne & mood changes in fact a celebrity Dr recently said “You do not need a period, for anything other than fertility!” Well, this statement could not be further from the truth when it comes to bone health.

Bones need to grow to the optimal size, shape & strength. During childhood & into teen years, bone grows to reach “peak” density & strength, called peak bone mass. At this point bones are the densest and strongest we will ever achieve. For women, peak total hip and femoral neck BMDs accrue during ages 16–19.

Many variables are associated with higher peak BMD incl genetics, age at first period, more physical activity / less sedentary time, higher calcium/vitamin D3 intake. Why is the age of the first period important? The production of oestrogen & progesterone that follow menarche together with growth hormone, & insulin-like growth factors (IGFs) interact to modulate the changes in bone size, geometry, mineral content, & microarchitecture.

In the UK, nearly a quarter of women 16–49 are regular oral contraception pill users, evidenced in the 2021 paper in Frontiers Endocrinology “Combined oral contraceptives (COCs) and intramuscular depo medroxyprogesterone
(DMPA) can compromise the expected gains in adolescence by altering oestrogen and IGF concentrations”.

The action of synthetic oestrogen-progestogen combined oral contraception acts by inhibiting ovulation. Depo Provera is a long acting contraceptive hormone injection, that releases a synthetic progestogen (this is NOT progesterone) slowly into the body, suppressing oestrogen & preventing the ovaries releasing an egg, thereby stopping the natural release of progesterone.

Both natural oestrogen & progesterone are required for bone health, through stimulating the bone-building cells called osteoblasts. The synthetic forms do not replace natural production. In fact Pfizer (producers of Depo-Provera) are involved in a $2.2 million class action lawsuit settlement for women that took their drug and suffered declines in bone density.

Again, of course, contraception is every young woman's right of choice but so is informed consent!

My colleagues are equally as passionate on this topic as I, and this is fully on the agenda to discuss at our Hormone Whispers event on 3rd Sept. Come along and get fully informed - we have 8 tickets left!

INSULIN: When you have a basic idea of how insulin works in your body, then you are on the right path to making changes to your diet and lifestyle—and figuring out what works for YOU.

I recognize there are so many factors that influence or interfere with the insulin pathway and how it regulates blood sugar, including perceived stress, activity level and fitness, as well as your microbiome.

But here’s the basic mechanism of insulin resistance or block.

Your cells have receptors, which respond to specific hormones.

Receptors are like locks on a door. Receptors for insulin are present in target cells, primarily, liver, muscle, and fat cells.

Insulin is the KEY that fits into the lock (receptor) to open the door to allow glucose to enter into these cells.

What happens when that lock is jammed? Insulin receptors in the liver and muscle become RESISTANT to insulin and the key no longer fits in the lock. Excess glucose may be deposited as fat.

When there is a rise in blood glucose levels from too much glucose intake (combined often with excess stress, lack of sleep, and insufficient exercise, among other factors) and receptors start to struggle, insulin levels rise accordingly.

The pancreas works hard to keep up with the demand for insulin. Insulin shouts LOUDER. Imagine insulin banging on the door of the cell, like an irate neighbor, who complains about everything. In the beginning, the cell is willing to listen and eventually opens the door. But soon the cell can’t be bothered to get up and open the door anymore. The receptor is becoming jammed, or increasingly numb to the voice of insulin.

Then a vicious cycle is off and running.

Insulin keeps knocking more and more loudly. The cell ignores the knocking. This is Insulin Resistance or Block. The cells become numb to insulin and glucose levels in the blood continue to rise.

Late in the process, cells that are still willing to open the door are fat cells. Excess glucose may be stored as fat. The increased levels of insulin are now promoting fat STORAGE over fat BURNING.

Adipose tissue EXPANDS to accommodate the excess glucose and we gain weight, especially fat in the belly and in/around abdominal organs.

Long COVID: A Fascinating Look at This New Epidemic’s Similarities to Chronic Fatigue Syndrome We’re all familiar with the widespread concern that spread across the globe like wildfire with the emergence of COVID-19 in early 2020. But now, years later, this tricky virus proves to be much more complex than a straightforward, passing infection. It’s estimated that nearly a third of those th...

What are the options when you need to augment your progesterone?

Pills work remarkably well if insomnia is your main symptom of low progesterone.

Prometrium is bioidentical, micronized progesterone: natural progesterone that has been broken down—micronized—to enable your body to metabolize it more easily. Taken orally, it is identical to the progesterone you’ve always made while cycling. It helps you sleep restoratively.

A word of caution: use Prometrium, not Provera (medroxyprogesterone acetate), the most common progestin, or synthetic form, of progesterone. Many physicians prescribe progestins to patients suffering from irregular periods, fibroids, and/or heavy bleeding.

But progestins cause terrible mood problems. In my opinion, it should not be used.

Though the words frequently are used interchangeably by physicians and the media, progesterone and progestins are different biochemically, which means they have very different effects on the body.

In study after study, Provera has been shown to increase the risk for breast cancer, depression, weight gain, blood clots, and cardiovascular disease (stroke and heart attacks).

Prometrium has been shown to be safe. One study, of more than 80,000 women followed for eight years, showed no increased risk of breast cancer when using Prometrium.

An important point about progesterone is that one of its main security jobs is to protect the endometrial lining from overgrowth, precancer (hyperplasia), and cancer. The only bioidentical progesterone shown to prevent buildup in the uterine lining is Prometrium.

Prometrium, taken in 100 mg or 200 mg tablets, can do anything progestins can do, but better and more safely. (Occasionally, women need higher doses to correct estrogen dominance, or for improved sleep.) The only contraindication is a peanut allergy because Prometrium is suspended in peanut oil in a soft-gel sphere. Women with peanut allergies might consider compounding natural progesterone in another base oil, which would have to be ordered by a physician who’s comfortable working with a compounding pharmacy.

BOTTOM LINE make sure your doctor prescribes bioidentical progesterone, NOT progestins, for you.

Hypocortisolism, or low cortisol, occurs when your adrenal glands are unable to make a normal amount of the main stress hormone, cortisol.
There are several reasons for low cortisol that are not stress-related including:

▪primary adrenal insufficiency (Addison's disease)
▪congenital adrenal hyperplasia (CAH)
▪secondary adrenal insufficiency.

I find low cortisol in some people who experienced a traumatic event early in their lives. However, for reasons not yet understood, not everyone with severe trauma develops low cortisol.

Sometimes I see low cortisol in women who are suffering from low thyroid. If the hypocortisolism is undiagnosed or inadequately treated, thyroid medication may work only temporarily or completely fail to help with symptoms.

It’s important to pay attention to the fact that high cortisol (hypercortisolism) is a precursor to low cortisol (hypocortisolism).

Constant stress and elevated cortisol can lead to adrenal dysregulation over time where you can have both high and low cortisol—even on the same day, within a twenty-four-hour period. Over time, consistently elevated cortisol levels can lead to low cortisol which makes you feel exhausted and drained, like a car trying to run on an empty gas tank.

Low cortisol is the end game of an overtaxed stress-regulating system.

Irritability, burnout, and depression are common symptoms, along with low blood pressure, orthostatic hypotension (which is when your blood pressure drops when you stand and you feel light-headed), and uncharacteristic pessimism.

Adrenal health is one of the key differences between my precision medicine approach to wellness and that of the traditional medical establishment, which holds that the adrenals are unimportant unless they completely fail, or are extremely overactive (that is, you have Cushing’s Disease).

Stress resilience and adrenal wellness are the foundation of health and vitality, and I believe that it is largely unrecognized and under addressed in conventional medicine.

Read a recent interview I did with on low cortisol
https://www.wellandgood.com/symptoms-of-low-cortisol/

Scientists are learning something huge: The food you eat "switches on" your genome The latest evidence suggests that food “talks” to our genome, which is the genetic blueprint that directs the way the body works.

What is the normal cycle of the stress-response system?

▪The hypothalamus secretes corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) in response to stressful threat.

▪CRH signals the pituitary to make adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to make stress hormones, including cortisol.

▪Cortisol travels back to the brain. In the hypothalamus, cortisol turns off the production of CRH and AVP. In the rest of the limbic system, the cortisol turns off the glucocorticoid receptor (and stops the signal to make more cortisol) and turns on the mineralocorticoid receptor (keep making AVP).

What goes wrong?

The biggest problem in dysregulation of the HPA axis is a failure to suppress CRH, AVP, and ACTH, meaning that the stress response doesn’t get turned off properly. The result is that you keep feeling stressed even when the stressor or threat is gone.

The other thing that happens when you perceive stress is that glucocorticoids are released into the blood so that you can run or fight. This is powered by raising your blood pressure, heart rate, and blood sugar. If this happens every once in a while, say every three to six months, it’s normal, and the body adjusts accordingly right after.

But if you have genes that program you to anticipate stress, perceive a high level of stress, or recover slowly and/or poorly, excess stress hormones may become toxic to your system.

High levels of glucocorticoids shorten your telomeres, which may arrest some cells into the zombie-like state of senescence (where the cell is neither alive nor dead) and release chemical messengers that promote inflammation.

Most studies suggest that the imbalance that makes the HPA axis hyperactive occurs in people with anxiety, depression, or PTSD. Even more interesting, the heightened stress reactivity seems to predate the mental diagnosis and may be associated with certain genetic variations of the key stress genes presenting healthcare providers and citizen scientists with a golden opportunity to intervene before all the bad stuff takes over.

Do you want to know more about the stress genes?

It is no mystery that working out is vital to a healthy, happy body and mind.
We’re all aware that inactivity and sitting too much are bad.

However, there’s a middle ground with exercise that provides the greatest longevity benefits.

When you don’t exercise enough, it can harm your immune system, reduce your stress resilience, and dysregulate your circadian rhythm.

However, when you exercise too much— too long, too intensely, too frequently, and without sufficient recovery— you may cause problems to your stress-response system, leading to immune problems, injury, and a leaky gut (Zuhl, 2012).

Even if you aren't training for a specific event or sport, racking up countless hours on the road or treadmill will likely trigger an undesired hormonal response, which is not helpful if you are already trying to manage chronic stress or adrenal fatigue.

Overexercising releases two key hormones: Corticotropin-releasing hormone (CRH) and cortisol. CRH increases the permeability or leakiness of the intestinal wall as well as the permeability of the lungs, skin, and blood-brain barrier. Cortisol levels rise with rigorous exercise, such as running, which may cause too much wear and tear and accelerated aging (Piacentini, 2015; Brisswalter, 2013; Lac, 2000).

High cortisol also alters tight junctions between cells such that small harmful substances may pass through the barrier. Additionally, high cortisol reduces gut motility, blocks digestion, blunts blood flow to the gut, and lessens mucus production, an important immune function.

Elite athletes get help from several work-arounds, such as by supplementing with probiotics,omega-3s, and vitamin C; however, modulation may be your best bet.

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Several genes regulate your stress-response system.

Here are the most common ones:

▪FKBP5 is a gene well known to be associated with cortisol regulation, the stress-response system (fight-flight-freeze), the HPA axis, and risk of PTSD. A variant of the FKBP5 gene makes you potentially more vulnerable to stress.

▪CYP1A2 codes for an enzyme that makes you more likely to overstimulate the adrenal glands. It’s also the gene that makes you metabolize caffeine slowly. More than half the population are “slow metabolizers” and cannot tolerate more than 200 mg of caffeine without side effects.

▪FAAH also known as the Bliss gene, controls the enzyme that acts on anandamide, our natural cannabinoid molecule of bliss that makes you feel calm and happy.

▪MR gene controls one of the regulators of the HPA, the mineralocorticoid receptor, which programs us to have increased ACTH (the hormone that signals your adrenals to produce more cortisol) and cortisol in response to psychological stress.

▪TH, the gene that codes for tyrosine hydroxylase, makes the body freak out in a cold environment. I can’t go surfing in the cold ocean or sit in a bathtub of ice without feeling incredibly stressed. I have to live in a warm place or else my cats, short for catecholamines (stress neurotransmitters and hormones), and blood pressure rise too high. (It’s the same gene associated with white-coat hypertension.)

When it comes to stress, modern life is at odds with our ancient genome. We are hardwired to survive a rare threat and then chill out for a few months before the next crisis. Instead, psychological, emotional, or work related crises pummel most of us daily, hammering our cells with excess stress hormones and shortening healthspan.

If you don’t clear stress well, it can feel as though the factory forgot to install your shock absorbers. If this sounds like you, then you'll need to come up with your own. Program regular downtime to relax, unplug, slow down, and digest life.

How are your 'shock absorbers'?

Great work!

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