Women's Hormones Part 2 Flashcards
Hot flashes alternative tx
Acupuncture,
Hot flashes botanicals
• Black cohosh • Siberian rhubarb • Red clover • Non GMO Soy • Sage - dopaminergic effect
Take home message regarding adrenals and hot flashes
Estrogen set the rheostats, adrenaline triggers hot flash
Do not always correlate with estrogen levels, treat stress/sleep
Phyto SERMS/ isoflavones
effects
safe with
Soy, red clover
Attached to ER beta only, avoiding Cell proliferative affects of ER alpha
Help with bONEs, decreased breast cancer risk, help with depression and cognition, favorable for CV risk, safe in breast cancer.
Supplement for sleep with hot flashes
Phosphatidyl serine
5HTP
Passion flower
melatonin
Progesterone supplementation for hot flashes/ irregular bleeding
Chasteberry 1000mg daily or
Progesterone 100-300mg orally or
P 25-50 mg topically day 14 28 of cycle, [2 weeks on/2 off] if premenopausal or
day 8 28 if perimenopausal/menopausal
fibroids/endometriosis causes
think autoimmune dysbiosis LPS leads to low P toxins e dom
fibroids/endometriosis tx -
diet
supp
detox
gf diet detox: Methylated B’s catechins Milk thistle and other liver herbs Fiber sweating Exercise
Testosterone for low libido in women
Don’t GIVE can increase estrogen vis-à-vis aromatase and decreasing SHBG
Testosterone for low libido in women
Don’t GIVE can increase estrogen vis-à-vis aromatase and decreasing SHBG
CAN INCREASE BREAST CANCER
is a marker for low adrenal function
Fibroid fun facts
They make their own estrogen from circulating androgen
Inflammatory cytokines stimulate aromatase in fibroids
Vitamin for fibroids
vit d
Phyto SERMS/ isoflavones
Soy, red clover***
MELATONIN
Attached to ER beta only, avoiding Cell proliferative affects of ER alpha
Help with bONEs, decreased breast cancer risk, help with depression and cognition, favorable for CV risk, safe in breast cancer.
aromatase inhib
Fiber, soy, resveratrol, grapeseed extract, chrysin (passion flower tea, honey, propolis) white button mushrooms
detox foods
artichoke
Pomegranate,
watercress,
Green tea
cannabinoids
for cramps and libido
hormonal treatment for fibroids/endometriosis
25 50mg topically, 100 200mg orally day 12/14 28 of cycle
vit for breast cancer reduction
13. Vitamin D 14. Iodine 15. Melatonin 16. Essential oils frankincense, myrrh 17. Mushrooms turkeytail 18. Cannabinoids
Reduces SHBG
Obesity, insulin, testosterone, red meat
SEEMS botanicals
Resveratrol Genistein Enterolactones Lignans Catechins Isoflavones Quercetin
SEEMS and SERMS do what to SHBG
increase
ER Alpha
Stimulatory
er beta
= break
ER β inhibits ER α transcriptional activity at subsaturating
hormone levels.
•
ER β decreases overall cellular sensitivity to estradiol
Tissues with er alpha
is expressed primarily in the uterus, liver, kidney, and heart.
Tissues with both ER alpha and beta
bone brain breast thyroid thymocytes adrenal epididymis
16α-Hydroxy-estrone
HIGH affinity, carcinogenic, neutralized by reductase
2-Hydroxy-estrone
Minimal estrogenic effect
neutralized by COMT to become methoxy- protective
4-Hydroxy-estrone
(neutralized by COMT or) converted to quinones which are carcinogenic –> neutralized by glutathione
High levels of 16 α hydroxyestrone or a decreased 2:16 ratio
have been associated with an increased risk of hormone
dependent cancers
2-Hydroxy-estrone
Minimal estrogenic effect
neutralized by COMT to become methoxy- protective
low 2:16 ratio
= high Estradiol
higher risk of osteoporosis
Possible causes of low 2/16:
Obesity Increased net estrogen activity Alcohol consumption Autoimmune diseases : RA, SLE Pesticide exposure Low fiber diet Meds : oral contraceptives PCOS
DIM effect
more 2-Hydroxy-estrone and metabolites
Phase 1 Interventions to
Lower Estrogen Effect
Increase 2OH estrogens/decrease 16OH estrogens
Indole 3 carbinol, DIM Flax lignans (seeds, not oil) Soy and soy isoflavones Physical activity Omega 3 fatty acids: anti inflammatory Resveratrol Avoid alcohol Increased Brassica vegetables
COMT and breast cancer
COMT catalyzes Methylation (SAMe and Mg
•
Decreased COMT activity associated with increased breast
cancer risk through accumulation of genotoxic metabolites
MOST IMPORTANT Phase 2:
Interventions to lower estrogen effect
Sulfation - Glucosamine sulfate, MSM, NaSO4
Methylation - Folate (activated), vitamins B6 and B12, methionine, betaine (trimethylglycine), SAMe, MSM
Glucuronidation - Beta glucuronidase —-> calcium d glucarate, normalize gut flora, fiber from ground organic flax seed
FOLIC ACID CYCLE AND METHYLATION support
Important nutrients to Rx: Betaine(TMG), SAMe, B12, 5MTHF, B6, B2, Mg
Ideal HCY level 8 or less,
B12 > 600
Beta glucuronidase
dysbiosis leads to high levels which reconjugate estrogen and help it recirculate
RX for Enterohepatic Circulation
of Estrogens
• Calcium D Glucarate 500 1000mg bid • Fiber, Flax seed (organic and freshly • Avoid alcohol inhibition of liver metabolism • Treat GI yeast overgrowth : Mycoestrogens and ETOH from
Interventions to lower estrogen effect and improve excretion phase 3 detox
Flax lignans kill two birds with one stone
EPA regular bowel function (and anti inflammatory)
Magnesium to bowel tolerance
Probiotics
5R program when needed
Carminative herbs and spices for bile production
Cardamom, coriander, peppermint, chamomile, fennel, cumin
seems meds
MELATONIN
PROGESTINS
