UNDERSTANDING HORMONE HIGHS & LOWS

ESTROGENS “Estradiol, even Estradiol (E2) is the most potent of the three natural estrogens, at normal, which include estrone (E1) and estriol (E3). Estrogens play important roles in stimulating growth of the reproductive tissues, maintaining premenopausal healthy bones, increasing the levels of neurotransmitters in the levels, can brain, and helping keep the cardiovascular system healthy. cause estrogen LOW ESTRADIOL in premenopausal women is unusual unless they experience dominance an anovulatory cycle (no ovulation) or are supplementing with birth control pills, symptoms if which can suppress endogenous (made in the body) production of estrogens not balanced by the ovaries. A low estradiol level is much more common in postmenopausal women or in women of any age who have had their ovaries surgically removed by adequate (oophorectomy) and/or those who have not been treated with hormone progesterone.” replacement. Symptoms and conditions commonly associated with estrogen deficiency include hot flashes, night sweats, sleep disturbances, foggy thinking, vaginal dryness, incontinence, thinning skin, bone loss, and heart palpitations.

HIGH ESTRADIOL in premenopausal women is usually caused by excessive production of androgens (testosterone and DHEA) by the ovaries and adrenal glands, which are converted to estrogens by the ‘aromatase’ enzyme found in adipose (fat) tissue. When estrogen levels are high in postmenopausal women, this is usually due to estrogen supplementation or slow clearance from the body (sluggish liver function).

Excess estrogen levels, especially in combination with low progesterone, may lead to the symptoms of “estrogen dominance,” including: mood swings, irritability, anxiety, water retention, fibrocystic breasts, weight gain in the hips, bleeding changes (due to overgrowth of the uterine lining and uterine fibroids) and thyroid deficiency. Estradiol, even at normal, premenopausal levels, can cause estrogen dominance symptoms if not balanced by adequate progesterone. Diet, exercise, nutritional supplements, cruciferous vegetable extracts, herbs and foods that are natural aromatase inhibitors

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Copyright © 2020 ZRT Laboratory, LLC. All rights reserved. Revised 6.17.2020 and bioidentical progesterone (e.g., transference from someone using “Younger can help to reduce the estrogen progesterone cream), and/or sluggish women with burden and symptoms, naturally. metabolism. Transdermal (through the skin) progesterone is well absorbed regular cycles PROGESTERONE at physiological levels (10-30 mg/ generally Progesterone is manufactured in day). Progesterone results higher than make adequate the ovaries at about 10-30 mg of the reference range can occur with progesterone, progesterone each day during the topical doses greater than 30 mg. consistent latter half of the menstrual cycle (luteal Note: a significant number of individuals with their phase). Younger women with regular in this range are without adverse cycles generally make adequate symptoms, indicating that a high having fewer progesterone, consistent with their progesterone level is associated with symptoms having fewer symptoms of estrogen few side effects. Symptoms of high of estrogen excess. Progesterone is important progesterone are relatively benign excess.” in normal menstrual cycles, breast and include excessive sleepiness, development, maintaining pregnancy, dizziness, bloating, susceptibility to relaxing blood vessels and influencing yeast infections, and functional estrogen neurotransmitters in the brain. deficiency (more problematic when LOW PROGESTERONE in premenopausal estradiol levels are low/low normal). women is more commonly seen with RATIO OF PROGESTERONE/ESTRADIOL anovulatory cycles, (no ovulation), The ideal ratio of progesterone/ luteal insufficiency (ovulation with low estradiol ranges from 100-500 in progesterone production), or use of premenopausal and postmenopausal contraceptives containing synthetic women supplementing with progestins. A lower level of progesterone progesterone. The ideal ratio is is more common in postmenopausal not useful in postmenopausal women who no longer ovulate, who have women with low estrogen levels had their ovaries removed, or who use and women on synthetic hormones; synthetic progestins in HRT (Provera). e.g. oral contraceptives or conventional Synthetic progestins are not detected hormone replacement therapy (HRT). by the highly specific immunoassays used to quantify progesterone. TESTOSTERONE

HIGH PROGESTERONE in normal Testosterone is an anabolic hormone premenopausal and postmenopausal produced predominately by the ovaries women can occur with excessive in women and the testes in men, and supplementation, incidental exposure to a lesser extent in the adrenal glands. It is essential for creating energy,

HORMONE HIGHS & LOWS | Patient HandOut 2 maintaining optimal brain function syndrome. Symptoms include loss of “Slightly elevated (memory), regulating the immune scalp hair, increased body and facial hair, testosterone system, and building and maintaining acne, and oily skin. Supplementation with the integrity of structural tissues such as topical testosterone at doses in excess of (range 50- skin, muscles, and bone. Premenopausal levels produced by the ovaries (0.3-1 mg) 60 pg/ml) is testosterone levels usually fall within the or testes (5-10 mg) can raise testosterone often seen in high-normal range and postmenopausal to levels beyond physiological range. postmenopausal levels at low-normal range. In men women as they testosterone levels peak in the teens DHEA and then fall throughout adulthood. DHEA Is a testosterone precursor shown transition into to have direct effects on the immune menopause.” LOW TESTOSTERONE is most commonly system independent of testosterone. caused by aging, removal of the ovaries or testes, suppression of ovarian and DHEA and its sulfated form, DHEAS, testicular production by stress hormones are produced predominately by the (cortisol), use of contraceptives and adrenal glands. Youthful levels are synthetic HRT, and/or damage to the at the high end of the range; levels ovaries, testes and adrenal glands decrease with age and are usually at the by trauma, medications, or radiation lower end of normal in healthy middle- therapies. Chronically low testosterone aged individuals. Athletes tend to have can cause loss of bone and/or muscle higher than normal DHEAS levels. Low mass, erectile dysfunction, thinning DHEAS can be caused by adrenal skin, vaginal dryness, low libido, exhaustion and is commonly seen in incontinence, fatigue, aches and pains, accelerated aging and diseases such depression, and memory lapses. as cancer. High DHEAS is associated with insulin resistance/PCOS (polycystic HIGH TESTOSTERONE is usually the ovaries) or DHEA supplementation. result of excessive production by the ovaries, testes and adrenal glands CORTISOL or supplementation with androgens Cortisol is produced by the adrenal (testosterone, DHEA). Slightly elevated glands in response to stressors, both testosterone (range 50-60 pg/ml) is daily (e.g. waking up, low blood sugar) often seen in postmenopausal women and unusual (e.g. emotional upset, as they transition into menopause. High infections, injury, surgery). Cortisol testosterone in premenopausal women levels are highest in the morning, and is associated with polycystic ovarian then drop steadily throughout the day syndrome (PCOS), which in turn is to their lowest point during sleep. caused by insulin resistance/metabolic

HORMONE HIGHS & LOWS | Patient HandOut 3 Cortisol is essential in regulating and supplements are often helpful in “While normal mobilizing the immune system against correcting low cortisol (hypoadrenia). levels of cortisol infections and reducing inflammation. It HIGH CORTISOL suggests some are essential for helps to mobilize glucose, the primary energy source for the brain, and form of adrenal stress (see above), life and optimal maintain normal blood sugar levels. supplementation with topical functioning of hydrocortisone or use of corticosteroid While normal levels of cortisol are other hormones, medication. Heightened cortisol essential for life and optimal functioning particularly production by the adrenal glands is of other hormones, particularly thyroid a normal response to routine stress thyroid hormone, chronically elevated levels and essential for health; when stress is hormone, can be detrimental to health. Stress chronic and cortisol output remains high and persistently elevated cortisol chronically over a prolonged period (months/years), levels can contribute to premature elevated breakdown of normal tissues (muscle aging and chronic illness. levels can be wasting, thinning of skin, bone loss) and LOW CORTISOL, particularly if low immune suppression can result. Common detrimental throughout the day indicates adrenal symptoms of chronic high cortisol include to health.” exhaustion, caused by some form sleep disturbances, fatigue, depression, of stressor, e.g. emotional stress, weight gain in the waist, anxiety. sleep deprivation, poor diet, nutrient deficiencies (particularly low vitamins For more information and recommended C and B5), physical or chemical reading please visit www.zrtlab.com. insults (chemo, radiation) or synthetic glucocorticoid medications that suppress cortisol production. Chronic stress depletes cortisol and is associated with symptoms of fatigue, allergies (immune dysfunction), chemical sensitivity, cold body temp, and sugar craving. Symptoms of thyroid deficiency can also stem from low cortisol. Adequate sleep, gentle exercise, meditation, proper diet (adequate protein), ‘bioidentical’ progesterone, adrenal extracts, herbal, and nutritional

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