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IFMCP > Sex Hormones > Flashcards

Sex Hormones Flashcards

1
Q

Testosterone def diagnosis

A

Serum < 300 on 2 samples

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2
Q

Subtypes of low T

A

Central (brain): low FSH/LH
Primary (gonadal): low T (FSH, LH normal)
Elevated prolactin

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3
Q

Role of aging in testosterone

A

declines starting in 20s-30s, associated with inflammation and chronic disease

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4
Q

70% of adult-onset hypogonadism have this chronic condition

A

metabolic disease

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5
Q

Common conditions assoc with low T

A

chronic opioids, obesity, metabolic syndrome, diabetes, AIDS, HTN, dyslipidemia, ED

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6
Q

Which heavy metal is assoc with low T?

A

Cadmium

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7
Q

Side effects of T replacement

A

acne, apnea, edema, baldness, elevated cholesterol, gynecomastia, infertility, testicular atrophy

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8
Q

Lifestyle to support endogenous T

“Production”

A

exercise, weight loss
nutrients - A, D, zinc
sleep and stress
test for and tx cadmium

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9
Q

Transport protein for T

“Transport”

A

SHBG

decrease SHBG to liberate testosterone: exercise, nettle root, EPA/DHA, whey protein

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10
Q

Modulating androgen receptors

“Sensitivity”

A

exercise: increases androgen receptor density in skeletal muscle
nutrient to increase sensitivity - vit A
manage estradiol (via aromatase and 5 alpha reductase) as it increases DHT and androgen receptors in the prostate

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11
Q

“Detoxification” to support T

A

inhibit aromatase and 5-alpha reductase (address body fat, insulin, leptin, inflammation)
tx cadmium if present

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12
Q

5 alpha reductase inhibitors

A

saw palmetto, nettle, quercetin, green tea, soy isoflavones, chrysin, lysine

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13
Q

aromatase inhibitors

A

lignins from flaxseed, green tea, soy, resveratrol

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14
Q

which vitamin can increase total T?

A

vitamin D

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15
Q

which two factors can increase aromatase?

A

insulin, alcohol

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16
Q

Nutrients and botanicals for BPH

A

B-sitosterol, Pygeum africanum, rye grass pollen extract

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17
Q

Which vitamin can prevent prostate hyperplasia?

A

vitamin C

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18
Q

nutrient that acts as weak inhibitor of 5-alpha reductase

A

zinc

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19
Q

nutrient that can decrease PSA

A

Selenium

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20
Q

anti-inflammatories for prostate health

A

quercetin, cranberry

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21
Q

Where is estrogen primarily produced?

“Production”

A

ovaries and adipose (via aromatization)

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22
Q

Which hormone stimulates aromatase?

A

insulin

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23
Q

Aromatase is elevated in which conditions?

A

fibroids, endometriosis, breast CA

24
Q

Does the endometrium have aromatase?

A

No

25
Q

SHBG is increased in these conditions

A

pregnancy, hyperthyroid, aging, cirrhosis/hepatitis, HIV

26
Q

SHBG is increased by these meds/supplements

A

exogenous estrogens, anticonvulsants, vit D

27
Q

SHBG is increased by these diets

A

low fat

low protein/vegetarian

28
Q

SHBG is decreased in these conditions

A

DM2, obesity, metabolic syndrome, hypothyroid, nephrotic syndrome

29
Q

SHBG is decreased by these hormones

A

insulin, IGF-1, GH, androgens, progesterone, prolactin

30
Q

SHBG is decreased by this lifestyle thing

A

exercise

31
Q

to decrease estrogenic effect, what should you try to do to SHBG?

A

increase it

32
Q

Ways to modulate estrogen receptors

“Sensitivity”

A

supplement with weaker phytoestrogens

soy isoflavones, kudzu, cohosh

33
Q

Estrogen “Detox”

Nutrients to support phase I

A

DIM, I3C, cruciferous veggies, lifestyle

phase I adds a OH group

34
Q

3 Phase I estrogen metabolites

A

2-OH: “good”, very weak estrogenic effect, protective against breast CA

4OH: “very bad”, carcinogenic via quinones

16OH: “bad”, full estrogenic effect, carcinogenic

35
Q

Causes of low 2OH:16OH ratio

A

obesity, alcohol, RA, SLE, hypothyroid, low fiber, OCPs

36
Q

Phase II estrogen detox (3)

A

Sulfation
Methylation
Glucoronidation

37
Q

Ways to support Phase II estrogen detox: sulfation

A

sulfur donors

glucosamine sulfate, MSM, NaSO4

38
Q

Ways to support Phase II estrogen detox: methylation

A

folate, B6, B12, methionine, TMG, SAMs, MSM

39
Q

Ways to support Phase II estrogen detox: glucoronidation

A

calcium-d-glucarate, fiber, probiotics

40
Q

Estrogen dominant conditions

A

headaches, PMS/PMDD, mastalgia, fibrocystic breasts, fibroids, endometriosis,

41
Q

Estrogen dominance causes

A

obesity, inflammation, alterations in estrogen metabolism, alcohol, dysbiosis, endocrine disruptors

42
Q

Luteal phase dysfunction s/sxs

A

luteal phase <11 days or low serum P
may have low FSH, E, LH
frequent menses, spotting pre and post

43
Q

Luteal phase dysfunction conditions

A

anorexia, obesity, infertility, early miscarriage, HMB, stress, thyroid dz, hyperprolactinemia

44
Q

Luteal phase dysfunction causes

A

SAD, low fat/low cal, excess exercise, stress, hypothyroid, PCOS

45
Q

LPD supportive nutrients

A 
vitamin C
black cohosh
vitex
vit E
B6
avoid meats with hormones
46
Q

Fluctuations in hormone levels conditions

A

perimenopause, major stress, illness, abnormal response to normal fluctuations (e.g. PMS/PMDD)

47
Q

Hormonal insufficiency conditions

A

aging, menopause, POI, HA

48
Q

Suboptimal hormone metabolism examples

A

SNPs, alcohol, endocrine disruptors

49
Q

Using serum testing in women

A

post-menopausal, bound and unbound

50
Q

Using salivary testing in women

A

measures free hormones only

51
Q

Using urine testing in women

A

metabolites

52
Q

This condition is characterized by estrogen dominance + progesterone def + stress

A

PMS

53
Q

This condition has estrogen dominance with LPD

A

PCOS

54
Q

Nutrients to support PMS

A

B6

Vitex

55
Q

Nutrients to support PCOS

A

inositol

56
Q

Functional med approach to treating fibroids and endo

A 
Aromatase inhibitors: fiber, lignin from flax seed, soy, resveratrol
plant-based diet
normalize insulin
GI/5R
Support detox
Reduce estrogen levels
Topical or oral P

IFMCP (9 decks)

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