Although most of the patients I deal with are female, there are also many men who deal with thyroid and autoimmune thyroid conditions. And of course I personally battled with Graves’ Disease before following a natural treatment protocol. Just as is the case with women, many men also have a hormone imbalance which needs to be addressed. Because of this I thought it would be beneficial to dedicate a post which discusses the male hormone pathway, and how to detect and correct a hormone imbalance.

Here are some of the symptoms which can result due to an imbalance of the male steroid hormones:

• Low mood
• Loss of energy
• Problems with concentration and memory
• Blood sugar issues
• Weight gain
• Sleep issues
• Prostate problems

A Basic Breakdown Of The Androgen Pathway:

The pathway which forms the male hormones is actually very similar to the female pathway. It all begins with cholesterol, which is then converted into pregnenolone, and from this point it divides into two separate pathways. One potential pathway is for the pregnenolone to be converted into progesterone, which in turn will convert into the adrenal hormones, aldosterone and cortisol.

Pregnenolone also converts into DHEA, which in turn gets converted into the male steroid hormone, androstenedione, which in turn gets converted into testosterone. Testosterone in turn can convert into either DHT or estradiol. Different enzymes are involved in the conversion process, as 5-alpha reductase is involved in the conversion of testosterone to DHT, while aromatase is involved in the conversion of testosterone to estradiol, as well as androstenedione into estrone.

Hopefully this will give you a better understanding as to why a hormone imbalance may take place. For example, if someone has low testosterone levels, bioidentical tesosterone is commonly recommended as the solution. However, since DHEA is a precursor to testosterone, then if one has low DHEA levels then this very well can be the underlying cause of the low testosterone problem. So in this case bioidentical DHEA should be taken, right? Well, not necessarily, as it depends on how low the DHEA is. Plus, an herb such as Tribulus might be able to raise the DHEA levels, which in turn can help raise the low testosterone levels. Either way, the goal in this case should be to find out why the DHEA levels were low, as this is usually due to chronic stress over a prolonged period of time. Of course not every case of low testosterone is caused by low DHEA levels, but the point I wanted to make is that most medical doctors don’t look at the whole picture.

So what’s so bad about taking biodentical testosterone in the above scenario? Well, besides not addressing the underlying cause of the problem, an excess of testosterone will convert to estradiol, which can lead to the condition known as estrogen dominance. Some medical doctors are aware of this and thus will also recommend an aromatase inhibitor so that this conversion can’t take place. But besides the potential side effects of these inhibitors, they once again don’t address the cause of the low testosterone.

Prostate Problems Can Be Caused By A Hormone Imbalance

Many of the prostate problems men have are also caused by an imbalance of the steroid hormones. This isn’t always the case, but for someone with BPH or another prostate issue, not at least looking at the hormones is ludicrous. And once again, just looking at testosterone isn’t enough, as since the hormones interact with one another it really is important to get a complete picture.

How To Detect A Male Hormone Imbalance:

In addition to the symptoms a male patient may be experiencing, here are some of the tests which can help determine whether someone has a hormone imbalance:

1. Male Hormone Panel. If you have been following my posts for awhile then you probably know I recommend the company Diagnos-Techs for hormone testing. They have an expanded male hormone panel which will show the levels of DHEA, androstenedione, testosterone, DHT, progesterone, estrone, and estradiol. The expanded version of the panel (which is the one I recommend) includes FSH and LH. The reason why you want to look at these hormones is because these hormones stimulate and regulate the formation of sperm (FSH) and testosterone production (LH).

2. Hair Mineral Analysis. Although this test doesn’t directly measure the hormones, an imbalance in certain minerals can reveal a hormone imbalance. For example, an imbalance in the ratios of zinc and copper can mean that the person has an imbalance in the hormones estrogen and progesterone. This test can also give adrenal, thyroid, and blood sugar indicators.

3. Cholesterol levels. Since cholesterol is a precursor to all of the hormones, it of course is important that people have a sufficient amount of it. Most people are concerned about their cholesterol levels being too high, but it also can cause problems if these levels are too low.

Correcting A Hormone Imbalance

So once a hormone imbalance is detected, how can one correct this problem? Well, it depends on what type of hormone imbalance is taking place, and what the cause is. For example, if the imbalance is due to misfiring of the pituitary hormones FSH and LH, then one needs to provide support to the HP-Axis in order to correct this problem. If the problem is low DHEA due to a prolonged stress response, then of course one needs to modify the stress response, and may need to give adrenal support to raise the DHEA levels. Sometimes a purification program can help with a hormone imbalance as well.

So I hope that all of the men reading this have a better understanding behind the physiology of the hormones. It’s definitely a complex system, and it’s important to realize that giving bioidentical hormones can help at times, but this isn’t the solution for every hormone imbalance, as sometimes natural hormones can do more harm than good at times.

Many people with thyroid and autoimmune thyroid conditions have a hormone imbalance. While most people I consult with haven’t received any type of hormone testing, some people have had such testing, and usually it has been serum testing done by their medical doctor. While this type of testing can be useful, there are some flaws you need to be aware of. Although you might think this doesn’t pertain to you, just keep in mind that many people have an underlying hormone imbalance but are unaware of it. So just in case you ever need to receive any type of hormone testing, I would take a few minutes to read this information carefully.

The Differences Between Serum & Saliva Testing

I’ve discussed this in other articles and posts before, so I won’t go into much detail here. But the primary difference between the blood tests and the saliva tests is that most blood tests measure the bound form of the hormone, while saliva testing measures the free form of the hormone. 99% of the hormones in the bloodstream are in the bound form, and are released when necessary. But it’s the 1% of the free hormone that we need to look at with regards to these tests. Of course the free hormone can be looked at under serum tests.  This is obvious when looking at the thyroid hormone levels, as with serum testing one can look at the Total T3 or T4, or the Free T3 or T4. Similarly, it is possible to look at the free levels of estrogen and progesterone.  The problem is that it is more expensive, and therefore most medical doctors simply order the bound form of the hormone when it comes to estrogen and progesterone.

This is why I recommend saliva-based testing. While such testing isn’t cheap, it’s less expensive than the free serum tests. Another advantage is that it’s non-invasive, and you can do it from the comfort of your own home. Some question the accuracy of this test, but the main questions arise simply because we’re so accustomed to blood tests. So we make the assumption that blood tests must be more accurate than saliva tests, or else medical doctors would recommend saliva-based testing to all of their patients. But as usual, it all comes down to the training they receive in medical school, as you probably have guessed that they don’t teach medical doctors about saliva testing in school, and so it shouldn’t be a surprise that most medical doctors frown upon such testing.

One-Sample Testing In Cycling Women Is Inadequate

Another major flaw with conventional testing of hormones is the following: taking a one-sample test of a cycling woman doesn’t give a complete picture of what is happening with her hormones. I can understand using serum testing on a menopausal women, although once again, one should evaluate the free form of the hormone. On the other hand, it doesn’t make sense to draw a one-sample test for someone whose hormone levels are in a constant state of fluctuation. I’m not suggesting that one-sample testing of cycling women is completely useless, as there is some value, but it’s definitely not sufficient to see if someone has an existing hormone imbalance. Just because a woman doesn’t have an imbalance at one point during her cycle doesn’t mean doesn’t have an imbalance at other points.

For example, if you are a cycling woman and you visit your medical doctor for a one-sample serum test on day #17 of your cycle, and if everything looks fine, this doesn’t mean there isn’t an imbalance on day #11, day #21, etc. Keep in mind that the in the first half of the cycle, estrogen is the dominant hormone, and then in the second half of the cycle progesterone is supposed to be the dominant hormone. So at the very least you would want two samples taken a few weeks apart. But even this wouldn’t be sufficient, which is why a saliva-based cycling female hormone panel will require a cycling women to collect a saliva sample every few days of her cycle.

One of the big reasons why you want to obtain multiple samples is because you’re looking at the output of these hormones throughout the cycle. This is especially true in the second half of the cycle when progesterone is the dominant hormone, as you want to look at the total output of progesterone, and not just the levels on a specific day.

Monitoring The Levels Of Someone Taking Bioidentical Hormones

More and more doctors recommend bioidentical hormones to their patients. What many don’t understand is that these hormones are in the free form, yet most medical doctors use serum tests to follow-up on these patients, which as you know by now only detect the bound form of the hormone. What commonly happens is that people who use natural estrogen, progesterone, and testosterone creams will overdose, but the serum tests won’t reveal this because they’re only showing the bound form of the hormone. So if they’re going to use serum testing to monitor their patients who are taking bioidentical hormones, they should look at the free form of the hormone.

So hopefully you now have a better understanding of the differences between serum-based hormone testing and saliva-based hormone testing. While the serum-based tests have some value when it comes to menopausal women, you need to remember that they don’t measure the free form of the hormone. And when it comes to testing the sex hormone levels in cycling women, a one-sample serum test won’t give a complete picture of what’s happening. Finally, when taking bioidentical hormones, if someone is overdosing then serum-based testing won’t reveal this since bioidentical hormones are in the free form of the hormone.

Many holistic doctors are critical of medication. To be honest, I’m guilty of this too at times, as while I know that both prescription and over-the-counter medications are sometimes necessary, many drugs are both overused and abused. This applies to thyroid medication as well, such as Methimazole, Tapazole, Synthroid, and other thyroid medications. I do think that many people can benefit from taking these drugs on a temporary basis, and some people need to take them on a long-term basis.

In any case, the goal of this post isn’t to discuss medications, but instead is to discuss herbal medicine. While I’m frequently talking about how thyroid medication doesn’t do anything for the cause of the condition, and how there are risks with conventional treatment methods, it is rare for me to talk about the “risks” of using herbs. And I’m not just talking about self-treating one’s condition, as I’m just talking about the general use of hebal remedies, as while there are definitely risks of taking herbs when self-treating one’s condition, there can also be risks even when under the guidance of a healthcare practitioner.

Remember That Not All Herbs Are The Same

I have discussed in the past how not all nutritional supplements are the same. There are of course different qualities of nutritional supplements, and the same concept applies to herbs. For example, with certain herbs it is more beneficial to use the root part of the plant, when compared to the leaf. Of course the consumer usually doesn’t know this, and in some cases the doctor isn’t aware of this either. Many holistic doctors don’t know much about herbs, and to be frank, I fit into this category when I first began seeing patients many years ago. But in addition to taking an extensive herbology program by a well know herbalist named Kerry Bone, I’ve attended numerous seminars and have done a lot of studying on my own. But there was a time when I didn’t know much about herbs, and I’m still learning about them to this day.

When talking about the “risks” of herbs, usually there won’t be any adverse reactions when someone takes an herb consisting of the leaf instead of the root. It very well may impact it’s effectiveness, but it usually won’t cause the person any harm. Of course by not being effective this in turn can cause problems, not to mention waste the person’s money. My goal here isn’t to promote any company which provides quality herbal products, but one needs to understand that there are a lot of companies out there which do sell low quality herbs. So without question I recommend using companies that have quality herbs, and quality herbs aren’t cheap.

The Difference Between Liquid Herbs and Tablets

Although I do recommend herbal complexes to my patients that are in tablet form, one major disadvantage of tablets is that there is increased processing. Most of the time the liquid herbs are more effective than tablets, although it is definitely more convenient to recommend the tablets, and in many cases it is also easier for the patient to take tablets. For example, the company MediHerb has a product called Thyroid Complex, which is a tablet consisting of Ashwagandha, Bladderwrack, and Bacopa. While this is a great product and I do recommend it to my patients, taking the liquid herbs can be more effective. But besides it being more expensive to purchase the liquid herbs, it is more convenient to take the tablets. This is especially true if you need to take them away from your home, as you can simply put the tablets in a pill holder, whereas it’s more challenging to carry the liquid herbs with you, although this definitely is possible.

When I was initially diagnosed with Graves’ Disease I took a combination of tablets and liquid herbs.  I took Bugleweed and Motherwort in liquid form, and for awhile I took Echinacea in liquid form before switching to a tablet.  I also took a number of different herbs in tablet form, such as Eleuthero, Licorice, and another tablet which consisted of numerous herbs for immune system support.

Keep in mind that not everyone with Graves’ Disease needs to take all of the same herbs I took. And course just because an herb is in liquid form doesn’t automatically mean it’s of good quality. Once again, there are different qualities regardless of whether the herb is in a tablet or liquid form. This may seem like common sense, but some people assume that an herb in a liquid form is always of a high quality, which of course isn’t always the case.

Herbal Interactions With Prescription Drugs

Are there dangers when taking certain herbs, along with prescription and over-the-counter drugs? There definitely can be, which is why you need to be careful. For example, St. Johns Wort is contraindicated when taking certain medications. For other herbs, there are “cautions”, but not necessarily contraindications. Truth to be told, many herbs are safe to take and have no known contraindications when taken with any type of medication. On the other hand, other herbs do have some contraindications.

Can’t you just do a search online and/or refer to a book to see what type of interactions there are when taking specific herbs? I would be cautious about relying on information on the internet, although there are some books on herbal remedies which do provide some good information. As you know, I’m an advocate of speaking with a holistic doctor who has experience dealing with herbs on a frequent basis.

How about the interactions of herbs with thyroid medication? For those people with hypothyroidism or Hashimoto’s Thyroiditis taking synthetic thyroid hormone, or for those with hyperthyroidism and Graves’ Disease taking antithyroid medication and/or beta blockers, are there risks when taking certain herbs? In most cases, taking these prescription drugs with herbal remedies won’t be a problem, although once again, it’s always wise to consult with a natural healthcare professional who has a good deal of experience dealing with herbs. Of course some people have sensitivities to certain herbs, and so this also needs to be considered. For example, if someone is allergic to the herb Feverfew, they will most likely have a reaction regardless of whether they are taking thyroid medication.

Plus one also needs to be careful regarding the dosage of the herb they are taking.  As an example, if someone with a hyperthyroid condition is taking Methimazole or PTU, and if they also decide to take Bugleweed, if they take too high of a dosage of this herb then this can actually lead to the development of a hypothyroid condition.  On the other hand, someone with hypothyroidism who is taking synthetic or natural thyroid hormone and then takes some herbs which stimulate the production of thyroid hormone very well might become hyperthyroid.  So you need to be very careful.

There are also certain contraindications one needs to be aware of. One obvious example is that someone with a hypothyroid condition shouldn’t take an herb such as Bugleweed, which is specifically for people with hyperthyroid conditions.  Bugleweed is also contraindicated during pregnancy and lactation.  Also, since many people with thyroid and autoimmune thyroid conditions have compromised adrenal glands, it’s important to know that someone with high blood pressure needs to be careful about taking the herb licorice, which is commonly recommended for people with low cortisol levels.

In summary, there are some risks when taking certain herbs. Many of the herbs are safe, even for those with thyroid and autoimmune thyroid conditions. Upon consulting with people, many are taking herbs on their own without experiencing any problems. So it admittedly is rare to have an adverse reaction. However, it does happen from time to time, and of course one shouldn’t just randomly take herbs based on what they read on this or any other website.

I’ve discussed the condition estrogen dominance numerous times on my website, as many people have this condition, and this includes both men and women. This frequently is due to a deficiency in progesterone, but it can also be due to an excess of estrogen. This is especially true when people take bioidentical hormones. In any case, I’ve been asked by some people whether or not taking aromatase inhibitors can effectively prevent estrogen dominance from developing.

Before I answer this, it’s probably a good idea to explain what an aromatse inhibitor is for those people who aren’t familar with these. Aromatase is an enzyme which helps in the production of the estrogens, as it specifically converts testosterone to estradiol, and androstenedione to estrone. There are drugs specifically manufactured to help inhibit the conversion process, which of course is why they are called aromatase inhibitors. There are also some natural aromatase-inhibitors which I will discuss shortly.

When Are Aromatase Inhibitors Used?

They are used in numerous different conditions. For example, since breast and ovarian cancer involve the hormone estrogen, aromatase inhbitors are commonly used in the treatment of these conditions. Body builders also may use these when taking steroids, as if they don’t take an aromatase inhibitor then the excess testosterone will convert to estradiol, which will result in estrogen dominance. Some medical doctors will give these drugs to their patients when recommending bioidentical testosterone to address a deficiency. In all of these examples, the goal is to preven the formation of estrogen.

If you have been a long time visitor to my website then it shouldn’t surprise you that I’m not a big fan of aromatase inhibitors. I’m not saying that in some cases they aren’t necessary to use, but they of course don’t get to the underlying cause of the problem. For example, if someone has low testosterone levels and is given bioidentical testosterone to bring up the levels, and then is given an aromatase inhibitor to prevent the testosterone from converting to estradiol, then this isn’t addressing the cause of the low hormone levels. Once again, I’m not suggesting that it’s never necessary to give bioidentical testosterone. On the other hand, I know some doctors who will give it to every single patient, even if they don’t show a deficiency. I definitely don’t agree with this approach.

Side Effects Of Aromatase Inhibitors:

Of course just as is the case with most prescription drugs, there are potential side effects. Some of the common side effects include fatigue, joint and muscle pain, as well as hot flashes and night sweats. There are also other less common side effects one might experience.

How About Using Natural Aromatase Inhibitors?

There are also natural aromatase inhibitors, and I’ve had some people ask me as to whether these are effective in preventing estrogen dominance from occurring. Natural aromatase inhibitors can be effective, but it depends on the situation. For example, if someone is addressing a low testosterone condition by giving small amounts of bioidentical hormones, then a natural aromatase inhibitor can prevent the conversion from happening. Of course if one is taking a small amount of testosterone then one shouldn’t need to worry about excessive conversion to estradiol.

Some natural aromatase inhibitors are more effective than others. For example, flaxseed oil is an effective aromatase inhibitor due to the high concentration of lignans. Flavinoids can also be effective, along with pumpkin seed extract. In fact, when I attended a seminar by Dr. David Brownstein, who uses bioidentical hormones a great deal in his practice, he stated that “Pumpkin seed extract has been shown to reduce aromatase by 50%”. He also mentioned how pycnogenols have been effective at blocking estradiol production.

So hopefully you have a better understanding of how aromatase inhibitors work, and realize that while they might be necessary at times, the overall goal should be to get to the cause of the problem so they won’t be needed.  And if it is necessary to take an aromatase inhibitor, then you might want to consider some of the natural options I discussed in this post.