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December 12-14, 2005 in Las Vegas, NV
The following is a synopsis of the presentations by Dr. Thierry Hertoghe, Dr. Jackie Springer, Dr. Suzie Schuder, Dr. Jess Groesbeck, Dr. Pamela Smith, Dr. Ron Rothenberg, and T.S. Wiley at the Third Annual Symposium of The International Hormone Society. The symposium was December 12-14, 2005 at the Bally Hotel complex in Las Vegas.
Paula Smith, MD.
Dr. Smith is an internationally known speaker and author on the subject of wellness and anti-aging.
Dr. Smith discussed the book, “Menopause and the Mind,” by Claire Warga, New York, New York Free Press 1999. A syndrome of estrogen deficiency includes foggy thinking, being forgetful, losing a train of thought and a fluctuation in the ability to prioritize. Interesting elements of estrogen’s effect on the brain and memory were noted; for example estrogen increases the availability of glucose to the brain, increases cerebral blood flow, helps to prevent ischemia, helps to maintain elasticity of blood vessels and increases the resting rate of metabolism in the body.
Jackie Springer, M.D.
Dr. Springer is an endocrinologist in Overland Park, KS.
Dr. Jackie Springer presented several cases of individuals with serious diseases such as amyotrophic lateral sclerosis and individuals with serious brain/head trauma.
She discussed Parkinsonism. She made a number of interesting conclusions from her review of the research one was that growth hormone, IGF-1 and estrogen protect against Parkinson disease, coming from a loss of dopamine.
Current drugs used for Alzheimer’s disease such as donepezil actually increase IGF-1 in that they stimulate growth hormone release from the brain.
She presented a case of a 48-year-old man who had a posttraumatic brain injury with global dementia out of the right frontal lobe. This was reversed in 18 to 24 months with intensive hormone treatment.
Dr. Jackie Springer presented two of the most recent studies in the medical literature. She presented several studies that perhaps are some of the first indicating the loss of longevity and life by those who have diminished amounts of growth hormone. She presented a genetic study on dwarfism in an isolated area in Switzerland, the Samnaun people. It is a very important study.
C. Jess Groesbeck, M.D.
Dr. Groesbeck is a psychiatrist in Mt. Vernon, Washington.
Dr. Groesbeck presented on depression; he noted a different approach to understanding hormones, citing that one could name several of the Greek gods or goddesses as the presiding personality definition for hormones! For example:
- Hestia; the goddess of thyroid, the goddess of the hearth
- Athena; the goddess of DHEA, she supported the heroes as daughter of Zeus
- Asclepius; the god of Cortisol, the god of healing, whose basic healing image was a wounded healer which motivated him to heal others. That certainly illustrates cortisol very clearly.
- Hercules (the great worker), Apollo (the sun god who did many things and presided over many activities of human life), and Eros (the god of love for men); All three of these gods were gods of testosterone; certainly these gods illustrate testosterone’s strong reputation.
- Hypnos (God of sleep) and Thanatos (God of night); the gods of melatonin
- Zeus (the king of all hormones and the king of all the gods); the god for growth hormone.
Dr. Jess Groesbeck presented on prostate cancer. Factors considered in prevention of prostate cancer include: waist/hip ratio obesity (with abdominal obesity), lack of physical exercise, vasectomy, alcohol use, too few vegetables and fruits, high fat intake, heavy milk products and testicular atrophy.
Dr. Jess Groesbeck further discussed the new theory of the evolution of prostate cancer. Rather than put the blame on testosterone which is benign and is conventionally taught. He shifted the view to a more complex picture that stromal changes in the prostate leads to hypertrophy and then prostate cancer which is caused by excess estrogen, particularly the 2 “bad estrogens,” 16-hydroxy and 4-hydroxy estrogen. However, as men get older their testosterone and dihydrotestoterone levels go down and their estrogen levels go up. These changes set the stage for benign prostatic hypertrophy and eventually prostate cancer.
He discussed one of the reasons for this is that the testosterone load by men being converted into estrogen; which is a natural process in younger years relating to the mating situation. A male who wants to mate with a female has the overwhelming urge from testosterone stimulation to overpower her for sexual gratification. If this was all there was the female would lose interest and run from the experience. During the maturation process there is a shift, which some of the testosterone, through the aromatase conversion, will turn into estrogen bringing on warm, loving and tender feelings in the male to complete the love relationship sexually.
As stated these are natural processes as we age. However, into the 40s men begin to change and some men begin to become “estrogen converters.” These men convert more of their testosterone to estrogen leading to the bad estrogens, 16 and 4-hydroxyestrogens. This excess estrogen contributes to the development of stromal abnormalities, setting the stage for prostate cancer. This is also noted to be connected to the inflammatory process discussed by Dr. Ronald Rothenberg in his discussion on inflammation.
It was explained then that what was needed for prostate cancer prevention/treatment were 2 important elements:
<!--[if !supportLists]-->1. <!--[endif]-->For estrogen converters in men, there needs to be a block from converting testosterone to estrogen, and this can best be done through an aromatase inhibitor such as Arimidex 25 mg a day p.o. or better Aromasin 25 mg a day or every other day.
<!--[if !supportLists]-->2. <!--[endif]-->Second element is di-indole-methane recommendation, this is a product of indole 3-carbinoll, a natural product from broccoli which helps convert the good estrogens or the 2 hydroxy estrogens.
Dr. Jess Groesbeck discussed sleep deprivation and sleep difficulties, thyroid, cortisol and DHEA, cases of individuals with chronic fatigue syndrome, significant sleep problems and multiple other problems. Their condition was considerably ameliorated with the composite use of thyroid, DHEA, growth hormone and testosterone as being significant in their recovery. A more extensive summary cannot completely touch the detailed comprehensiveness and wide range made in this most remarkable seminar, chaired and led by Dr. Thierry Hertoghe, who in this writer’s opinion is the world’s leader for the understanding of hormones, again an outstanding success.
T.S. Wiley is the author of ‘Sex, Lies, and Menopause’.
MultiPhasic Cyclical Hormone Therapy; cyclic hormone therapy with bioidentical (estrogen/progesterone) E2/P4 developed and presented by Ms. Wiley.
She postulated that natural hormone replacement or bioidentical hormone replacement (B-HRT) is best versus the use of conventional synthetic hormone replacement, particularly concerning the estrogens. Cogently, that “hormones are molecules that translate environmental cues – when to eat, when to sleep, when to mate - to all systems in the body, not just the brain, in terms of behavior.” From the perspective of evolutionary biology, the point of physical existence is to mate. The bioidentical hormones do this best she said.
She presented a basic outline of the Wiley protocol. It is a multiphasic cyclic dosing system with a lunar calendar and as close to nature as possible. Diagnostic markers of improvement reveal an original kinetic profile with transient estrogen and progesterone plasma levels as markers of efficacy and safety. She noted that blood work is done on E2 and P4 and is drawn in the a.m. on day 12 and day 21 of the 28-day cycle. Blood levels are used to compare to healthy reference ranges of young pre-menopausal women, the logical assumption being that young women rarely experience heart disease, breast or uterine cancer, osteoporosis, vaginal dryness or Alzheimer disease. She noted that the multiphasic cyclic dosing regimen is a new paradigm called B-HRT. Where “Real hormones” (only plant-derived) are used. Real replacement is multiphasic cyclic dosing with the menstrual period on day 28. Real solutions point to the majority of menopausal symptoms being eradicated with a vast improvement in sleep and libido. Several interesting cases she presented illustrate the importance of this approach.
Ron Rothenberg M.D.
Dr. Rothenberg is renown in the field of anti-aging medicine.
He gave a presentation concerning chronic fatigue, fibromyalgia, chronic pain, the Gulf War syndrome, the sick building syndrome and infection with Candida. He gave an impressive presentation, demonstrating that at the core of many of these illnesses is chronic inflammation. Chronic inflammation is the core of most of the diseases of aging.
He noted NF-kB, nuclear factor kappa beta, is central to inflammatory pain, atherosclerosis, cancer, cognitive functions, fatigue and more. He noted that PGE2 can be controlled by NF-kB control. This is an important point!
AGE2 comes from arachidonic acid which comes from animal fat and the omega 6 pathway in foods, and this could be controlled with omega 3s and NSAIDs. He stated the nuclear fat kappa beta controls Cox and Lox. This is controlled by levels of stress, depression, adipose tissue, antioxidants, exercise, omega 3 fatty acids, nutrition (with insulin control), homocysteine, hormone levels and ratio and balance in the omega 6/omega 3 pathways.
He described the good and bad eicosanoid. He ended up recommending that omega 3 fatty acids should be taken as 1 tablespoon equaling 8 grams a day. He also recommended avoiding a lot of red meat.
This remarkable presentation dovetails and coincides exactly with recommendations by Nicholas Perricone in his diet that is anti-inflammatory. There were further discussions and details of cytokines with chronic fatigue, fibromyalgia and chronic pain.
Suzie Schuder, M.D.
Dr. Schuder is a psychiatrist in Newport Beach, California.
Dr. Schuder presented on chronic fatigue syndrome and cortisol.
Cortisol levels are associated with variable symptoms of chronic fatigue syndrome and cortisol insufficiency. The chronic fatigue syndrome with hydrocortisone in bio-equivalent dosages, small doses of a physiologic level, not in excess because this could cause Cushing disease.
Dr. Suzie Schuder made perhaps the most unique and striking presentation of the whole conference. Questions:
- What is Romantic Love?
- Sexual Desire?
- Emotional bonding?
- Something else or both?.
Increasing cortisol for twelve to twenty-four months increased testosterone in women and decreased testosterone in men.
She noted that romantic love and sex really are different brain systems! She stated brain waves turned on by romantic love only partially overlap with the areas activated by sexual arousal. She noted that the motivation to win rewards is a key factor in experiencing “being in love.” Romantic love is more powerful than sex. Review of romantic love shows that it is not an emotion; it is a reward-based drive consistent with activation of brain areas associated with rewards and drive. Romantic love lateralizes more to the right, pleasure in viewing an attractive face lateralizing more to the left. Romantic love is directed toward a specific mating partner. The brain stores data in the pattern, strategizes and monitors progress. Emotion is based on progress to the goal. If romantic love is going well, euphoria is the result. If uncertain, anxiety occurs. If thwarted, depression occurs.
Apparently there are 2 different stages in a three-part process of survival of the species. Phase I for species survival is less craving for sexual gratification driven by androgens and estrogens.
Phase II is romantic love for species survival. There is attraction fueled by goal-driven brain centers with high dopamine and norepinephrine levels, low serotonin levels characterized by euphoria when things are going well and terrible mood swings when they are not, focused attention, obsessive thinking, and intense craving for the individual.
Phase III in the phase of love for species survival is attachment. This attachment is to a long term partner with feelings of tranquility and stability, driven by oxytocin and vasopressin. There are noted to be higher vasopressin levels where the receptors have specific locations in the brain’s center.
In studies of monogamous prairie voles there is;
1. Sex drive for nonspecific courtship motivation
2. There is love Attraction system to pick and focus on a potential partner to save time and energy
3. Attachment: Creates stability for parenting roles.
She noted, strikingly, that elevated levels of testosterone can suppress oxytocin and vasopressin whereas also elevated levels of oxytocin and vasopressin decrease testosterone. Romantic love diminishes over time. One study showed the longest was 17 months of a sustained period. It progresses to attachment or the relationship ends.
The next hormone for attachment and pair bonding was oxytocin. She noted that they are the hormones of divorce. In divorced couples the first year levels of adrenalin were 34% higher in conflict, 22% higher throughout the day and adrenalin and noradrenalin were 16% higher at night. Couples who are troubled in the first year, the ATCH levels double and triple and the noradrenalin was 34% higher with conflict, 24% higher during the day and 17% higher at night.
She noted that love promotes wellbeing. Love, pleasure and lust have a stress-reducing and health promoting potential. It promotes the ability to heal, facilitate beneficial motivation and behavior and loving pleasure in shared survival with individuals in a species. Love is a joyful and useful activity that encompasses wellness and feelings as well as wellbeing.
She addressed testosterone and other hormones such as dihydrotestosterone, DHEA and pheromones. She noted that DHEA caused increased production of pheromones through sebum. This improves the libido in women and improves erectile dysfunction in men. She noted that as people age, pheromones, sexual scent, and love feelings diminish.
Dr. Suzie Schuder discussed hormone replacement, with psychotherapy, hypnosis with pain management and again some of the importance of oxytocin as it plays a part in psychotherapy.
Thierry Hertoghe, M.D.
Dr. Hertoghe is, perhaps, the best known author, lecturer, and physician practicing aging related medicine and advanced hormone therapy in the world.
Dr. Groesbeck stated, in the beginning of his presentation, “Is this mysterious man, Thierry Hertoghe, a man?” The answer is yes, he is Hercules, carrying the hormones of the world on his shoulders. Is he a messenger? Yes, he brings the messages from the gods of the hormones to all us as Hermes. Is he a god? Not yet, but he consorts with the god of hormones, Zeus, who is the god for the hormone growth hormone.
Testosterone and Memory was presented by Dr. Hertoghe
Deficiency in testosterone has significant impact, and affects memory, (i.e. loss of memory) in men. Low testosterone occurs with Alzheimer disease. To determine the testosterone free index (TFI) calculate 100 x the total testosterone level divided by the SHBG (sex hormone binding globulin) level. Result should be 100.
Testosterone also increases the intellectual determinates of learning and memory, spatial memory in men and women and mathematical performance in women. It reduces the easiness to talk fluently in women, however. It increases neuron connections and increases the antioxidant system. It also decreases the amyloid beta secretion.
Dementia and hormone deficiencies – Dr. Thierry Hertoghe presented on dementia. He noted that the causes of dementia can best be summarized by the word dementia,
E Emotional illness or depression
M Metabolic endocrine disorders
E Environment (yours)
N Nutritional neurological
T Tumors trauma
A Alcoholism, Anemia and Atherosclerosis.
He clearly defined the stages of dementia and development of symptoms, particularly as it leads to memory loss. He highlighted that memory deficiencies are expressed by specific deficiencies in growth hormones, testosterone, DHEA, estrogen, estradiol in women, progesterone, pregnenalone, cortisol, aldosterone, thyroid and vasopressin.
The therapy for chronic memory loss concerning hormones was discussed. One of the major hormones discussed, as it relates to memory loss, was growth hormone. Memory is improved through the elevation of IGF-1 via growth hormone. It was noted that growth hormone protects from Alzheimer disease.
He described a significant case in which he helped a man deal with his wife who had Alzheimer by giving her growth hormones, keeping her stable, and keeping her at home without having her go downhill and into the hospital before she died. He also emphasized that physical activity helps keep memory intact. The type of exercise was outlined as being that which is not forced but gentle and yet regular and systematic.
Traumatic brain injury was discussed and it was noted that these individuals often have lowered growth hormone levels. Obtaining high levels of growth hormone can sometimes have striking results with people with traumatic brain injuries. A focus on growth hormone and its effects on the brain were then discussed. It was noted that growth hormone decreases the amyloid-beta neurotoxicity particularly protecting neurons in the hippocampus. Amyloid-beta neurotoxicity is closely associated with Alzheimer disease.
Memory loss was next discussed. It was noted pregnenalone deficiency may be related to attention deficit disorder. It helps with memory and particularly those who may have spinal cord injury. The dose levels were 100 mg a day for four months and then 50 mg a day. Pregnenolone was noted to block the effect of alcohol on memory loss. Also it increased resistance to neurodegeneration.
The mechanism of memory enhancement by pregnenolone is through increased acetyl choline in the hippocampus. Pregnenolone tends to increase mitochondrial resistance. It also decreases amyloid beta and glutamate neurotoxicity. Pregnenolone also increased REM sleep. It is an important hormone in terms of memory disorder.
Dr. Hertoghe discussed thyroid and memory loss, particularly as it relates to attention deficit disorder. It is the hormone that needs to be considered when these issues come forth. It was emphasized that memory loss or Alzheimer disease should raise a red flag of low thyroid hormones. Thyroid increases brain blood flow, also cerebral glucose metabolism and increases brain excitability generally. It does this by increasing the dendrites and synapses of the neurons.
Dr. Thierry Hertoghe underscored the fact that in posttraumatic stress disorder growth hormone is the only hormone that has been shown that really ameliorates the symptoms.
Thyroid hormone and depression was presented. Thyroid treats and cures many forms of depression including major depression, atypical depression, bipolar disorder and melancholia. Treatment of depression for a hypothyroid individual not only cured depression but many other symptoms of hypothyroidism.
Dr. Thierry Hertoghe discussed growth hormone and depression and noted how growth hormone affects depression significantly, increasing mood and lifting many of the symptoms of depression. Dose of growth hormone was 0.10 to 0.25 international units per day. It was noted that sometimes people do well with 0.03 units to 0.04 international units.
Dr. Thierry Hertoghe presented on memory, mood and depression with DHEA in the brain. He stated that in each of these conditions DHEA can be effective in treating this condition. Growth hormone significantly affects fibromyalgia.
Dr Hertoghe discussed aldosterone and fatigue. He stated this was the most overlooked hormone. The hormone also helps with chronic fatigue and fibromyalgia. As far as the working together of hydrocortisone and aldosterone or fluordicortisone the synthetic hormone has to be used instead of aldosterone. He recommended doses of 0.1 mg to 0.2 mg a day.
He also presented growth hormone and chronic fatigue, noting again that growth hormone has a significant effect on chronic fatigue syndrome and growth hormone has been used in treatment for fibromyalgia, again discussing the details of this condition.
Dr. Hertoghe presented, for the first time, his description of what he called “hormone characters.” He described melatonin who is the good sleeper, calm, relaxed, fresh and in a good mood. A deficient character, though, sleeps poorly, is agitated, anxious and wakes up nervous, intense, tired and is in a bad mood.
Growth hormone-balanced character had permanent wellbeing, inner peace of mind and soul, excellent resistance to stress, important recovering capacity, easy problem-solving and energy even after night, whereas the deficient character has permanent “unwellness”, sleep problems, insufficient sleep, permanent anxiety without reasons, poor response to stress, dramatizes and collapses, requires excessive time to recover, difficulty finding solutions to problems and easy exhaustion. He does not eat enough protein.
The thyroid character was noted. The optimal thyroid character has quick intelligence and spirit, optimism, warm-heartedness, lively emotions and energy at rest. The deficient thyroid character, though, has slow intelligence, slow thinking, negativism, cold-heartedness and has dull, colorless emotions, fatigue at rest and especially when waking up. Sometimes, if they are type A personalities, they are quick and nervous, always doing everything, cannot stay still and are heavy coffee drinkers.
The cortisol-balanced character is the fighter who has well being and euphoria, copes well with stress, has a fighting attitude, works a lot, is clear thinking in stress, and is energetic in stressful situations. However, the cortisol-deficient character has outbursts of anger, anxiety and is oversensitive to stress. They avoid stress as much as possible, at work just does what is necessary, has confused thinking in stressful situations, lacks energy, tends to be paralyzed in stressful situations, is quarrelsome, paranoid and disproportionately aggressive and has bad dietary habits with sugar cravings.
The estrogen-balanced character is the lover, excited, optimismistic, permanent well-being, falls in love quickly, is active, has good memory and permanent energy, sometimes too alive which stress reactions and emotion, authoritarian or in rebellion and demands a lot of attention and care. The estrogen-deficient character is tired and depressed and often is a menopausal woman. There is poor interest, negativism, permanently depressed, low feelings of oneself, poor image of femininity. She shows no or scant reactions, poor memory and permanent fatigue.
The progesterone-balanced character is the peaceful and kind woman, calm, soft, gentle, with a permanent feeling of inner peace and relaxed. The deficient character is a nervous and hysterical woman, anxious, aggressive, dramatizes things and is tense.
The testosterone-balanced character is the athletic person, optimistic, permanent wellbeing, falls in love, self-assured, good memory, with permanent energy and is a small eater. Feels he is the best, knows better, authoritarian, you have to listen to him. The deficient testosterone and dihydrotestosterone character is negative in thinking, does not love people easily, is hesitant, feels unsure about himself, worries a lot, poor memory, permanent fatigue, irritability and authoritarian.
There was a long discussion of stress and anxiety as it relates to the pituitary gland and growth hormone. Growth hormone clearly helps combat anxiety and stressful situations. One significant finding was that transcendental meditation did not seem to help with growth hormone and that the effect of chronic stress is decreased growth hormone, skin and muscle atrophy, abdominal obesity, osteoporosis, and diminished resistance to infection. Hormone deficiencies were evaluated concerning cardiac mortality, breast cancer and other elements.
Deficient growth hormone and cortisol can produce posttraumatic stress disorder symptoms. Lowered anabolic hormones on a chronic basic can cause premature aging. He noted that children who are deficient in hormones and have deficient diets need thyroid and pregnenolone replacement.
Dr. Hertoghe then focused on diet, noting that avoiding sugar, alcohol and caffeine were essential for good hormone function. He noted the importance of avoiding alcohol and its serious problems. Adequate water intake decreases the risk of breast cancer, colon cancer, rectal cancer, urinary tract cancer, childhood/adolescent obesity, and improves the overall health in the elderly.
Potassium increases memory, carcinoma in mice. Alcohol increases the risk of breast cancer.
Fruits and vegetables have anticancer activity. It was noted that one should avoid toxic food as it increases the cancer risk. Sugar was not strongly recommended. Statistics for milk are very depressing in terms of increasing the rates of lung cancer, breast, prostate, rectum colon cancer and increased colon cancer deaths. Recommendation is to avoid all milk products. The worst ones are cheese, milk and buttermilk. There are lesser problems with yogurt and cottage cheese.
It is to be remembered these recommendations are highly consistent with the Pericone diet, which includes many of these recommendations and their anti-inflammatory qualities.