Hormone Therapy: Myths, Truth And Endocrinologist's Opinion

Ekaterina Young: I jokingly say about my medical specialty: "The queen of therapy is endocrinology." But there is some truth in every joke. After all, the human endocrine system is one of the most ancient. It appeared long before the nervous system. And I was always curious how she controls us, how she predetermines some processes. Despite the fact that I am an endocrinologist, this does not mean that I treat exclusively with hormones. I just have a clear understanding of how many processes occur within us, and this "knowledge" helps to find the right complex solutions.

“Hormonophobia” is still very strong in our country. Why? Because sometimes people are faced with the fact that as soon as an organ malfunctions, the doctor immediately prescribes hormones. And this is fundamentally the wrong approach. The patient tries to take hormonal drugs without providing the necessary conditions for their work and conversion, and as a result receives side effects, forever disillusioned with this very effective and currently most powerful tool for managing youth and maintaining the quality of life. But hormone replacement "age therapy" is now very relevant. Technologies are developing, and there are a lot of related tools.

Of course, sooner or later some alternative options will appear, but today there are no worthy and equivalent options.

However, as I said, just hormone therapy is not a panacea. I have a lot of patients who are interested not only in menopausal hormone therapy, but also in the state of the thyroid gland, the pathology of which is the scourge of our time. It is a very important gland of the endocrine system, which determines many factors of youth. Its state depends on the lifestyle that we lead, on the stress in which we are. Our body does not care what is the trigger of stress, its task is for us to survive in these conditions, and accordingly, for this, all processes are triggered by a certain biochemical mechanism. It is with this cascade of biochemical reactions within us that we need to work.

If you simply diagnose "decreased thyroid function", then sometimes hormones will help solve this problem, and sometimes not. The study of these nuances led me to an integrative direction of medicine, which is also called the "functional" or "holistic" approach. The direction is quite young, but developing by leaps and bounds. This is my growth zone, where I develop, trying not just to hang out in science, but to adapt the acquired knowledge to practice.

Today they say that a person can live up to 120 years, because it was originally laid down by nature. But the main question is not how long to live, but how to live - with what health, with what mood.

I am convinced that the possibilities of the body and psyche are endless, which means that active longevity is possible, and we definitely need to work on its quality, and not just chase after the number of years lived.

There are undoubtedly over-ambitious destinations when looking for a pill of immortality and hoping to find it. I still have a more down-to-earth view. Nevertheless, I think that how to spend the allotted time on earth is definitely worth considering seriously. And here, of course, the topic of genetics comes to the fore. People need to understand that genetics is not a sentence. Today, such a direction as gene therapy is gaining momentum. I personally spoke with Liz Parrish, Patient No. 0. She is unique. In 2015, in Colombia, Elizabeth introduced genes to herself with the help of viral vectors, which introduced a new genetic program into her body and triggered the formation of large amounts of telomerase (an enzyme that lengthens telomeres). It is the shortening of telomeres that is associated with age and aging: when they are shortened, a person grows old. So,over 5 years Liz Parrish's telomeres have lengthened. So far, such "gene therapy" is a controversial and delicate issue.

Elizabeth's act caused a huge amount of controversy, but nevertheless such a unique case exists. I repeat, I met her personally at a scientific conference and I must say that she has changed a lot outwardly - in 5 years she has visually rejuvenated by 20 years. Something from the Benjamin Button series happened. So, despite some ethical points, from the point of view of science and from the point of view of certain hopes, this is something amazing, it is admirable. Of course, the long-term consequences have not yet been assessed and so far only external and internal benefits are visible. But there is something to dream about.

Okay, youth. But gene therapy is developing not only in this area. The same Liz injected herself with a gene that increased the amount of muscle tissue that gradually decreased with age. And she really grew muscles. Again, I see great prospects in such therapy for the treatment of genetic diseases. After all, there are people who are born with a genetic predisposition to insulin resistance, to being overweight, to Alzheimer's disease … This is all the scourge of our time. And here two topics should come to the fore - nutrigenomics and epigenetics. Epigenetics is the influence of the external environment on the implementation of our genetic program, what we inherited from mom and dad. Nutrigenomics is how nutrition can influence gene expression. Here nutrition becomes a chic and exciting tool for managing health and investing in active longevity.

Nutrition is not only about calories, proteins, fats and carbohydrates, food is signaling molecules that start our metabolism according to a specific program. Proper nutrition through the lens of genetics is in our hands. This is something that completely and one hundred percent depends on us. Because we ourselves form the food basket. It is in our power to observe the regime, in our power to assess the impact of stress, in our power to create conditions for getting out of stress. There is always stress, and that's okay. Our task is to learn how to get out of it and recover effectively. And I say with full responsibility that this can be done for free. Anti-aging is considered to be very expensive. This opinion is true and not. Indeed, there are tools to prolong youth, improve the quality of the skin, drugs and much more that doctors prescribe,requiring certain material costs. But you still need to get to the doctor. Until that moment, it would be nice to put things in order in our own body ourselves - and this is completely in our hands. The main responsibility for health and active longevity lies with us, and not with doctors who know something, not with Instagram bloggers who make beautiful pictures and write well.

First of all, in order to understand what is happening in the body, you need to go through a full genomic analysis (here it is expensive, but, as they say, "it's worth it"). In addition, you should assess the body at the biochemical level: look at the function of the thyroid gland and check if there are deficiencies of substances such as iron, copper, zinc … Recently I was at a conference in Las Vegas on the topic of Anti-Age, where clear evidence was presented the relationship of the state of the thyroid gland with the intestines.

Many scientists have said that sometimes the pathology of the thyroid gland is a consequence of an imbalance in the gastrointestinal tract. And having worked it out with proper nutrition, simply removing the inflammatory food groups, you can correct the situation - and correct it so much that hormones are not even needed.

On the one hand, we can really get a lot of useful things from food. But here the question invariably arises about the quality of what enters the body. Unfortunately, our foods are much poorer in terms of their nutraceutical composition than before. On the other hand, human needs for vitamins and nutrients in the realities of a metropolis, and even in a state of stress, are much higher than in the ecologically clean conditions of a Swiss village. My favorite example is about the banal vitamin C. The daily requirement for vitamin C is 75-150 micrograms. Indeed, here you can drink rose hips or currants and satisfy these needs. But a metropolitan resident may need 500 micrograms per hour … The difference is obvious. In our lifestyle, we really need more vitamins and minerals. And the biggest problemwhat leads us to drink nutraceuticals is the ability to absorb these vitamins and minerals. Before you drink something, you need to provide the conditions for it to be absorbed. And here, again, a lot is in our hands.

Digestion and assimilation begins with a look at food and with the state in which a person sits at the table. Because if this, again, happens in a state of stress, then there is no need to wait for the normal secretion of saliva and gastric juice, which means that you should not rely on the correct enzymatic cascade of converting proenzymes into active substrates, which begins with the production of hydrochloric acid. We throw food into ourselves like a shovel, we don't chew thoroughly - naturally, this is inadequately digested: the food ends up in the small intestine, where bacteria and fungi immediately rush, because the acid barrier simply does not work. As a result, we get absolutely not what we need, and it is only ourselves and the food culture improperly formed from childhood that are to blame for this, and not taking or not taking vitamins. What was the food culture before? Beautiful table setting,prayer before sitting down at the table. And prayer is a meditative state that balances a person, it is a certain physiology and preparation for eating. There was a practice of fasting, essentially the same as the intermittent fasting that is now fashionable. The theme of the Slavic feast is very healthy. You can rely on it to form the right habits.

Of course, you should not prescribe hormone replacement therapy with sex steroids right and left, because everything has its time, this is not candy. It is important to talk not only about menopausal hormone therapy, but also about preparation for it. The fact is that our genetics begins to be realized as soon as the level of sex steroids falls. You can be thin all your life, you can starve for a week before an important event or work out a little more in the gym - and you are in great shape. But at some point it breaks down and stops working. A person does not understand anything, menstruation is on, there are no hot flashes, that is, everything that is associated with age, everything is in place. Again, I am in favor of hormone replacement therapy, but you also need to prepare for it. This is accounting for genetics, the formation of a nutritional culture and so on.

Microbiota and hormone replacement therapy are highly intertwined things. Nowadays, hormones are available in tablets, ointments, gels, and candles - we have many tools in our hands. When used correctly, it is both the prevention of cardiovascular diseases, and the prevention of diabetes and osteoporosis. Knowing how to manage these tools, doctors can create conditions for most women to live comfortably at any age and give them a cool tool to prolong youth. There are many more advantages than disadvantages. Although there are also disadvantages - they are associated with possible weight gain, with the risk of developing certain diseases.

Lately menopause has gotten younger. It is a fact. This happened because we lead an ugly lifestyle: we do not cleanse the body, do not recover from stress, go to bed late, eat at random.

I will take the liberty of saying that the reason for early menopause is solely on the responsibility of a person who leads the wrong lifestyle, carelessly treats himself.

So everyone has their own start for hormone replacement therapy. After all, premenopause can begin even 15 years before the time when menstruation ends and hot flashes appear. These are the moments when sports, diets and everything that worked before stop working. These signals are already noteworthy. In addition, there are indicators for biochemical analyzes that we can look at once every six months or once a year, the same FSH and LDH, and track the dynamics. If suddenly they begin to increase, then this is an indirect sign that there have been changes in the hormonal background. In short, you need to learn to be attentive to yourself and be sure to make a regular check-up, and then choose a strategy to comfortably prolong your active longevity.

5 rules from Katya Young:

Live according to your circadian rhythms. Ideally, go to bed before 11 pm. The theme of owls and zhavoronkov is very inflated. Larks go to bed at 20 o'clock, and owls until 23 o'clock, but not at 3 or 4 am. There is a topic of sleep phase disturbance - this is a nosology, a scourge of our time, some scientists associate such a disorder with the stem that we are surrounded by a huge amount of artificial lighting and gadgets. There are, of course, rare people who stay up late, wake up late and feel good. But these are units.
To maximize the activation of the parasympathetic nervous system through singing, meditation, gargling.
Consume carbohydrates in moderation. Everyone has their own "moderate" - but up to 100 grams per day is quite acceptable. And if the doctor did not prescribe special restrictions, then definitely not less than 65 grams per day.
Relax your muscles with all possible options. Breathing practice, meditation, massage, osteopathy. The muscles should be soft.
Alternate work in sitting / standing positions. That is, the body should not be in a sitting position for an hour and a half. It is imperative to get up and move.

Photo: Zoltan Mihaly, Press Office Archives, Getty Images