Heather Locklear Hormone Deficient? by Candice Lane, M.D.

 

          Heather Locklear returned home on July 23, after spending a month in a spa-like treatment facility in Arizona for anxiety and depression. Articles imply she was already on medication and needed it adjusted. Certainly her recent public divorce is a reason for situational depression.

          With all due respect, I have one question. Has Heather had her hormones checked?  Now this might bring a collective groan, but think about it. Locklear is almost 47, well into the perimenopause and hormone loss. She looks young and beautiful, but our bodies have a relentless “biological clock” that cannot be ignored. We know that testosterone and progesterone are the first hormones to decline. Testosterone is linked to maintaining emotional shield and may prevent panic attacks. Progesterone deficiency causes irritability, mood swings, depression, and insomnia. Progesterone has a calming effect on the body by stimulating the calming GABA receptors in the brain. Add a little loss of estrogen which stimulates calming serotonin production, and emotional lability, weepiness, and depression can follow. Added to this is that the FDA has warned that anti-depressants themselves may increase depression and suicidality.

Medications like hormonal birth control or Prempro only make matters worse because progestins in these medications inhibit the production of the body’s progesterone and occupy progesterone receptors. I have had several patients lately on hormonal birth control come in with depression. They are on things like Mirena and Nuvaring, both of which secrete potent progestins (not progesterone) in the circulation that occupy progesterone receptors and deplete progesterone thereby preventing the calming effect of progesterone and natural hormonal balance. This effect may be more pronounced as we get older, since we are also losing our progesterone by our ovaries beginning to shut down. Post-partum depression is associated with a drop in progesterone after childbirth. Giving progesterone post-partum can prevent this depression.

          Stress makes matters worse. When we have stress our adrenal glands increase our production of cortisol which is our hormone that controls our daily sleep-wake cycle and our fight or flight response. The body will use all its resources to make cortisol, a hormone we cannot live without.  The body uses progesterone to help make cortisol, so stress situations may make progesterone levels lower. This may be the connection between stress and infertility. Chronic stress gives way to fatigue as the body struggles to keep up with the stress demand. Both adrenal stress and fatigue can further intensify depression through fluctuations in cortisol and progesterone. Relaxation may allow temporary improvement, but the perimenopausal body still continues its relentless progesterone and estrogen decline. In addition, adrenal fatigue and stress may effect thyroid function by altering the efficiency of how thyroid hormone is working in the body. Low thyroid function can cause depression. So treating hormone deficiency has to take all the hormones into account.

          All this may sound confusing, but it works. I recently had a patient that was on a few antidepressants and seeing a therapist. She balanced her hormones and within a few months got off all her medications and is feeling great. I personally had that experience as well. After 10 years of anti-depressants and counseling to no avail, I started on bioidentical hormones for perimenopausal hormones loss. I was able to get off all anti-depressants and am doing  better than ever with mood and outlook. (That’s an article in itself but we’re talking crying at the drop of a hat, irritable on the road and in parking lots, and general helpless and hopeless to doing just fine.) 

          Suzanne Somers’s has called anti-depressants, sleeping pills, and pain medicine, the “menopause cocktail”. As a former member of that club, I can attest to the truth of it. Initially, being uninformed and thinking I was still “young”, I did not put it together. It was only through proactive seeking that I found what was missing and that was my hormones. I recommend a good reading of Suzanne Somers’s “Ageless”. With bioidentical hormone replacement we can treat the underlying cause of our mid-life perimenopausal changes and be ourselves again.

 

Candice Lane, M.D.,  Diplomate and Fellow American Academy for Anti-aging Medicine, 1250 La Venta Dr., Ste.206, Westlake Village, CA 91361, 805-496-7869, 877-496-4289

Hormones, Osteoporosis, and Hip Fractures by Candice Lane, M.D.

 

Elderly women are at greater risk of death after a hip fracture than after breast cancer, according to a recent article in Medscape Medical News citing a study by Jane A.Cauley, DrPH,  at the University of Pittsburgh. The death rate was 48.1% after a hip fracture versus 25.1% after a breast cancer diagnosis.

What causes hip fractures?  Osteoporosis! Women with osteoporosis are the most likely to sustain a hip fracture. Osteoporosis advances rapidly after menopause due to the dramatic drop in hormones.

According to the National Osteoporosis Foundation, half of the women over 50 will have an osteoporotic fracture before they die. Half of the women surviving a hip fracture will not be able to walk and a quarter will need long term nursing care. A woman’s risk of hip fracture is equal to her combined risk of developing breast, uterine, and ovarian cancer.

Women are not the only ones who suffer from this problem. Men also get osteoporosis, although it is poorly recognized by the medical community.  Men typically develop osteoporosis slower and it appears later than in women.  Testosterone begins to diminish in the early 30’s and decreases 1-3%  per year, increasing the risk for bone loss. Men over 65 have a hip fracture rate of 5 in 1,000. Men over 65 are at risk and should have a bone density test done, as well as calcium, magnesium, thyroid, Vitamin D, and hormone levels.

            By 2010, over 52 million men and women age 50 years and older will either have osteoporosis or be at increased risk because of low bone mass per the National Osteoprosis Foundation. Approximately 20% of those that develop hip fractures will die the year after the fracture from surgery complications such a pneumonia or blood clots in the lung according to the CDC.

            The best therapy for osteoporosis is replacing lost hormones. In women, estrogen saves more bone tissue than very large doses of calcium according to the National Institute on Aging. In the May 2004 Journal of the American Medical Association, British researchers described a link between hormone replacement therapy and a reduced risk of bone fracture in post-menopausal women.

            Poor nutrition and inadequate intake of nutrients, lack of adequate exercise, unhealthy lifestyle including cigarettes and alcohol, and race also contribute to osteoporosis. Hormone replacement in men and women is of key importance for bone health.

            Replacemen with biodentical hormones is key. All three hormones are necessary in order to build and maintain bone: estrogen, progesterone, and testosterone. If you are taking Premarin, you are only getting an estrogen effect, and a dangerous one.You don’t want to trade one problem for another by taking alien synthetic molecules orally, like Premarin and Provera,  that can increase heart disease, stroke, and breast cancer. Remember all estrogen, even bioidentical, should be taken transdermally. Any oral estrogen can increase C-reactive protein which correlates with a higher incidence of heart disease. Provera or medrxyprogesterone has no benefit for bone, and in fact inhibits beneficial progesterone production and effects by binding to progesterone receptor sites.

            The synthetic pharmaceutical medications for osteoporosis, like Fosamax, are problematic. They do not allow for the natural turn-over and remodeling of bone and what you essentially wind up with is a lot of old brittle bone. In addition, one study showed that combining estrogen with Fosamax may increase fractures. In addition, Fosamax is correlated with bone problems in the jaw.

           Vitamin D is very important to build bone and prevent osteoporosis. Even in the sun belts, Vitamin D levels are low among men and women due to interior jobs, sun-screen over-use, and lack of ability of aging skin to convert sunlight to Vitamin D. Get your 25 hydroxy Vitamin D levels checked with a blood test, and if they are low step up your supplementation until they come up.

             Nutrient supplementation needs to be more than just calcium to build bone. Calcium citrate is OK, but calcium hydroxyapetite is best. Don’t exceed 1600 mg total of calcium per day unless you want calcium in your arteries and kidneys too. Other important nutrients for bone building are Vitamin K, magnesium, manganese, boron, and strontium. Othomolecular makes a great supplement that has all you need for bone maintenance or improvement of osteoporosis called ProBono. Patient report joints feeling better on it as well.

            Make sure you get a baseline bone density scan when you are in the perimenopausal years so you know where you are starting out. If you have osteopenia, take action. You can prevent osteoporosis!

 

Candice Lane, M.D., 1250 La Venta Drive, Westlake Village, CA 91361, 877-496-4289, 805-496-7869.

Menopause and Hormone Loss by Candice Lane, MD