I have been wanting to write about this for some time now, especially given the difficulty some doctors have in understanding what “Hormone Modulation” is.

I would say that hormone modulation is a combination of all the measures we can use to guarantee that the hormonal process occurs in the best way possible so that there is an optimization in forming, releasing, transporting, connecting to hormonal receptors, activation, hormonal metabolization and detoxification.

Administering hormones without taking hormonal modulation into consideration is an avoidable and unnecessary error which may lead to serious problems.

An example of how estradiol is metabolized in the woman. The hormone Estradiol is responsible for our energy, vitality, beautiful skin, vaginal lubrification, it helps avoid osteoporosis, works as a natural anti-depressive, enables us to sleep well, have a libido, and helps prevent innumerous complications that result from its absence in menopause. For example, it may be degraded into 2(OH) estrone, non-proliferative estradiol, “good”, via “normal” from metabolization, or the same estradiol, in the same body, may be degraded into 16(OH) estrone, bad proliferative estradiol, although most studies indicate that more 16 (OH) estrone than 2(OH) estrone may lead to a higher risk of breast cancer some 20 to 25 years later. And time flies by as we all know.

So, take note: “estradiol” can be dangerous! Yes, and No! Estradiol is a marvelous hormone for women, but our organisms can degrade it badly if we are not careful about our lifestyle. For example, metabolizing 16 (OH) estrone, is much more frequent in women who smoke, drink coffee and alcohol. Other common daily habits which are harmful for metabolizing are antibiotics, statins, enzyme conversion inhibitors and calcium channel blockers, anxiety medication and antidepressants.

Women are frequently told that “estradiol is dangerous”, and a woman who hasn’t been sleeping well, for example, because she is in menopause, will easily be prescribed anxiety medication or an antidepressant by her doctor. This often occurs because my fellow physician is “afraid” to prescribe hormones because she is unfamiliar with the importance of environmental integration, and epigenetics (the science that studies gene expression through one’s environment).

We doctors need to be aware of integrative and functional medicine. And some of us not only lack this knowledge but incorrectly advise and treat patients, often talking about things they do not know, saying that hormonal modulation is not a science. It seems that nowadays, most doctors feel they should be advising patients about hormones, an area that not long ago was a specialty dealt with, above all, by endocrinologists, gynecologists, and urologists. This is unfortunate because many of these professionals do not spend enough time with the patient, nor are they knowledgeable about this integrated and functional overview of medicine.

Patients today study up on the matter, know what they want, have access to information (good and bad) over the Internet, they seek out credible sources and doctors who are able to explain what is happening, and the best way to treat it. The advice these doctors give is grounded in a profound knowledge of biochemistry, physiology and physiotherapy, and they are better able to gain the patient’s trust and consequently greater adhesion for treatment, which will undoubtedly be more comprehensive and effective.

Although it is not okay, especially because they do not possess an in-depth knowledge about basic science, let alone the pathological process, many patients today auto-medicate due to the lack of confidence they may have in their physician, or because they are unable to find one that “understands them” and is able to answer their questions and clarify their doubts.

Medical schools continue to teach us to treat the disease. Many times they even encourage us to maintain it. No one teaches us how to treat health.

As if we did not understand the importance of prevention, and using up economic resources that will inexorably be gone in a not so distant future. Close to 95% of the money we will spend on medical treatment occurs after age 65, as most of us are aware. And longevity is in fact extending itself but at the cost of maintaining the disease, which is big business, one that is only surpassed by narcotrafficking.

It is all our fault and we should all fight to change this form of practicing medicine, for ourselves, as well as future generations. For a better world.

Doctors are trained to diagnose and prescribe medication. Most of us do not take one single course in nutrition; we never question the importance of nutrition and the other pillars in health prevention. We simply need to be very good at making a diagnosis for which a medication protocol has already been defined.

In my view, this is incorrect. At this rate, there would be no need for doctors or surgeons. We could just feed the signs and symptoms into a machine which would automatically generate a prescription. The waiting times would undoubtedly be shorter, lower immediate costs but more direct and indirect costs, as well as personal problems in a not too distant future.

I always give the example of hypothyroidism as it is the case I see most frequently amongst my patients.

The patient may present all the symptoms but since her TSH is “normal” she is not medicated. Nor treated. And treating the thyroid means treating the intestine, diet, checking to see if there is any interrelation to other hormones, eliminating toxins, correcting improper sleep habits and then eventually prescribing a pill. I have written innumerous times about the thyroid and why TSH does not really mean anything. To review.

We doctors must understand what hormone modulation is, and integrate hormone replacement into this concept for improved efficiency in our treatment.

Hormones do not work well without proper diet and nutrition. It is logical that without nutrients, hormones do not form. Without nutrients our cells are not prepared to respond to this hormonal signaling. Everything will go badly or less optimally given the body’s plasticity, a marvel of nature, which despite the daily aggressions inflicted upon it, the body tries to adapt and correct itself, until it is unable to do so and that is when disease sets in.

Nothing in our body is independent of hormone balance. From hair growth to the urge to urinate as I usually say.

We live in a world full of endocrine disruptors that we created in nature (over 100,000) and at any given moment our body has close to 200 toxic products inside it.

If hormones command all the chemical processes in our body and their performance can be disturbed by endocrine disruption, the first thing someone who wishes to undergo “hormone modulation” should do is learn a bit more about endocrine disruption, which I have also written about before.

Thus, modulating hormones, which is everything that leads to their optimization, encompasses paying close attention to diet (the source of the largest endocrine disruptors in our organism), physical exercise, food supplements, eventual hormonal replacement when necessary, and above all changing the patient’s habits to healthier lifestyle choices always looking to ensure that our hormones are working optimally.

We are doing hormonal modulation, when we eat healthily, when we exercise to the best of our potential, when we watch our intake of vitamins, minerals, control inflammation, oxidative stress, eliminate electromagnetic radiation and toxins.

Nutritionists with an integrated vision of functional nutrition are actually practicing hormone modulation. People who work in the field of physical education are too, and anyone who observes the five pillars of anti-aging medicine (nutrition, physical exercise, food supplements, hormone replacement and a healthy lifestyle), is also modulating their hormones.

Hormone replacement” however should only be handled by a doctor, and not just any doctor but a physician with a holistic, all-encompassing, integrated vision of medicine. Functional medicine should also be overseen by a specialist since it takes all the pillars into consideration to guarantee proper hormonal functioning.

Hormones will not work properly if they are administered into a cellular environment that is lacking in minerals, nutrients and vitamins.

Therefore, hormone modulation is in everyone’s hands, although the pillar of hormone replacement, which should be overseen by a doctor, should be seen by all physicians in an integrated form.

Any doctor who does hormone replacement should be able to enlighten the patient and possess solid knowledge in the areas of nutrition, physical exercise, handling supplements, know how to carry out hormone replacement, not via protocols but by understanding about biochemistry, physiology, physio-pathology and know how to analyze an analytical report, as well as which parameters need to be analyzed for a good clinical practice. We tend to spend more money the first time we conduct the process because we have to analyze many different parameters and many hormones since they may all be interrelated and interfering with one means we are interfering with the others. But we save money in the long run. Health subsystems do not like spending the extra money and doctors are hesitant to comply, and consequently we pay the price later. A doctor who does hormone replacement should be able to advise the patient on adapting a healthier lifestyle and have the time to do so.

Therefore, many endocrinologists do hormone replacement without doing hormone modulation.

Indisputably, endocrinology should be responsible for treating glandular hyper functioning, as well as hypofunctions associated to a concomitant pathology.

All medical specialties who see patients with signs and symptoms indicative of hormonal imbalances should at least know how to identify them and recommend the patient to a specialist in this area. In reality, all specializations should know about hormone modulation and know to treat them using hormone replacement and prevent the deficiencies that set in with age.

Treating the cause, understanding small analytical alterations, signs and symptoms because we have an in-depth knowledge of biochemistry, physiology and physiotherapy and are thus able to identify the small deficiencies before they become full-blown disease, should be the goal of every doctor.

Doctors from all specializations, including endocrinology, although these are the experts on hyperfunctions and the diseases already declared (or at least they should be, even though there are good and bad doctors of anti-aging medicine who denigrate the concept). They should know about hormone modulation and replacement as it applies to the Anti-Aging concept, preventing the appearance of future disease so that we are able to have more energy and vitality, better health and less disease.