salivary hormone testing part 3 nutritional support · pygeum africanum • traditional african...
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ChiroCredit.com/OnlineCE.com Presents: Intro To Hormones 102
Salivary Hormone TestingPart 3
Nutrition for Hormonal Supportby
Ronald Steriti, ND, PhD
© 2008
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Hormonal Support
• In this section, we will review herbs and nutrition that may be beneficial for hormonal support.
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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
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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
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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
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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.
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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.
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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
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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
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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.
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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
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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.
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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
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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
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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.
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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
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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
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Hormone Metabolism
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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
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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
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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
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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.
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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.
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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
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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.
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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.
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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
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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
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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
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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
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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.
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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.
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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
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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.
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Summary
• Phytoestrogens– Cimicifuga racemosa (Black Cohosh)– Trifolium pratence (Red clover)– Genestein and Dadzein (from soy)– Beta-Sitosterol
• Beta-glucuronidase inhibitors– Calcium D-glucarate
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Summary, continued
• Herbs– Vitex agnus castus (Chaste tree berry) – Pygeum africanum– Spearmint
• Nutrition– Vitamin E– Ipriflavone for bone density
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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)
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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.