functional medicine and nutritional genomics - American Association ...
functional medicine and nutritional genomics - American Association ...
functional medicine and nutritional genomics - American Association ...
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AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS<br />
given without concomitant progesterone<br />
supplementation regardless of whether or not the<br />
patient has had a hysterectomy. Balancing with<br />
adequate progesterone is not only important to<br />
prevent endometrial cancer, but will also protect<br />
the brain, the heart <strong>and</strong> the breasts iv<br />
. Estrogen<br />
doesn’t refer to a single hormone, but is rather a<br />
group of hormones that differ distinctly in molecular<br />
structure as well as in physiologic role. The<br />
human body produces three primary estrogens:<br />
estrone, estradiol <strong>and</strong> estriol. Estradiol is the<br />
most biologically active of the three, <strong>and</strong> therefore,<br />
one of the most commonly prescribed; however, it<br />
is best when given in combination with estriol v<br />
.<br />
Estriol (E3) is the weakest of the estrogens;<br />
though it binds to the same estrogen receptors, its<br />
action is significantly weaker. Because of this<br />
property, the presence of estriol can work to<br />
govern the proliferative effects of estradiol by<br />
competing for receptors vi . A combination of<br />
estradiol (E2) <strong>and</strong> estriol (E3) is often referred<br />
to as biest or two estrogens. The third estrogen,<br />
estrone, is not recommended for hormone<br />
replacement, as many of its metabolites are<br />
carcinogenic.<br />
Though there is much individual variability in<br />
estrogen levels, progesterone levels are almost<br />
always low in the peri <strong>and</strong> post menopausal<br />
population vii<br />
. It is the relative loss of progesterone<br />
compared to the decline in estrogen that causes a<br />
number of symptoms including breast tenderness,<br />
menstrual irregularities, mood changes, depression,<br />
tearfulness, foggy brain <strong>and</strong> more. The<br />
disproportionate loss of progesterone (termed<br />
‚estrogen dominance‛) begins in the latter stages<br />
of a woman’s reproductive cycle, when the luteal<br />
phase of the menstrual cycle begins to<br />
malfunction viii<br />
. Because the corpus luteum is the<br />
primary source of progesterone, when there is no<br />
ovulation, there is very little progesterone<br />
produced.<br />
The term ‚estrogen dominance‛ can be confusing<br />
at times because it is less related to the amount<br />
of circulating estrogen <strong>and</strong> more related to the<br />
ratio of estrogen to progesterone in the body.<br />
Symptoms of Estrogen Dominance include:<br />
� Mood Swings<br />
163<br />
� Irritability<br />
� Depression<br />
� Irregular Periods<br />
� Heavy Menstrual Bleeding<br />
� Hot Flashes<br />
� Vaginal Dryness<br />
� Water Retention<br />
� Uterine Fibroids<br />
� Decreased Libido<br />
� Headaches<br />
� Fatigue<br />
� Weight Gain: Hips, Thighs <strong>and</strong> Abdomen<br />
� Sleep Disturbance (Insomnia, less REM<br />
sleep)<br />
� Breast Tenderness/Fibrocystic Breasts<br />
� Bone Mineral Loss (Osteoporosis)<br />
� Short-term Memory Loss<br />
� Lack of Concentration<br />
� Dry, Thin, Wrinkly Skin<br />
� Thinning of Scalp Hair<br />
� Increased Facial Hair<br />
� Diffuse Aches <strong>and</strong> Pain<br />
Hormone imbalance, <strong>and</strong> particularly estrogen<br />
dominance, is not a condition that is limited to the<br />
menopausal population. In a cycling woman,<br />
progesterone is the hormone that should be<br />
dominant during the second half of the menstrual<br />
cycle ix . There are many factors that can affect<br />
the ability of the corpus luteum to produce<br />
adequate progesterone including stress, diet <strong>and</strong><br />
the use of exogenous hormones, such as birth<br />
control pills. The hormones found in birth control<br />
pills are not the same as progesterone produced<br />
by the body. Synthetic progestins differ<br />
significantly in molecular structure as well as in<br />
action x . While natural progesterone decreases a<br />
woman’s risk of breast cancer <strong>and</strong> cardiovascular<br />
disease, synthetic progestins increase it. The<br />
most famous study illustrating this fact is the<br />
Women’s Health Initiative, a large multi-armed<br />
research project that followed over 16,000 women<br />
for an average of 5.2 years <strong>and</strong> concluded that<br />
the participants who had been taking the progestin<br />
medroxyprogesterone acetate had a statistically<br />
significant increase in rate of breast cancer,<br />
2012