Tom Ballard, ND's blog

Hormone Replacement: Bio-Identical, synthetic, or…? (part1)

Tom Ballard, RN, ND

Bio-Identical hormones have become popular through celebrity endorsements, books, news reports and websites, yet few are aware of their dangers. Generally we are presented the message: as we age our hormone levels decline, so supplementation will help us become more youthful, energetic and fit. Oh, and we’ll also lose weight. If only health was that simple.


The term bio-identical hormone refers to the supplementation of hormones, usually estrogen or testosterone, that are biochemically identical to those produced in your body. They are usually compounded by small pharmacies, often mixing specific combinations as prescribed by a doctor for a specific patient. Advocates claim they are preferable to hormone preparations such as Premarin, which is produced from horse urine and is not identical to human hormones.


Bio-identical hormones hit the spotlight with the celebrity endorsement of actress Suzanne Somers. Numerous books and articles have been published on the supposed virtues of bio-identical hormones over so-called “synthetic” hormones. In addition to estrogen and testosterone, human growth hormone (HGH) is also sold as a bio-identical hormone.


One reason for the popularity of estrogen, testosterone and human growth hormone is that they often have immediate effects. The person often feels better, so wants to continue. This makes it difficult to convince patients that the long-term negatives may outweigh the short-term positive feelings.


Terminology in chaos

As usual with new things, especially in the health care arena, confusion abounds. While some are willing to receive their spoonful of medical advice from Hollywood starlets, others may want facts.



First, it is important to understand what a hormone is. A hormone is a chemical produced in a gland that travels through the blood delivering a message. It is a chemical messenger that regulates the functioning of the body.


The thyroid gland produces thyroid hormone and releases it into the circulation where it travels to most cells with the message to increase activity. A person with not enough thyroid hormone will typically be less mentally active, constipated, over weight, and feel letharic. Too much thyroid hormone might cause a person to be hyperactive, suffer diarrhea, and be thin.


Estrogen and progesterone are produced in the ovaries, testosterone in the testis. They are known as sex hormones because they influence sexual characteristics and function.


Cortisone is produced by the adrenal glands and is critical for adapting to stress. Stress could be anything from a cold virus to an attack by a bear. In stressful situations your body adapts by secreting more cortisone which raises heart rate, mental alertness, oxygen intake and other necessary responses.


Insulin is secreted by the pancreas and controls blood sugar levels. Type 1 diabetics are deficient in insulin and must take it by injection as it is not utilized when taken by mouth.


Human growth hormone (HGH) is produced in the pituitary gland. It stimulates growth and repair of tissues.


Other hormones such as human chorionic gonadatropin and lutenizing hormone are specialized to regulate women’s menstrual cycles and child birth.


You might say that hormones produced by your glands are “identical hormones.” They’re the real deal.


Synthetic hormones

Synthetic hormones are produced in a laboratory. A core molecule from a plant or animal is altered to be similar or identical to a hormone produced in the human body. Plants do not make human hormones, but they produce substances that are similar. These similar compounds are altered to make bio-identical hormones. Therefore, bio-identical hormones are actually synthetic. Synthroid and other synthetic thyroid hormones are given by mouth when a person’s thyroid gland is not functioning adequately.


Premarin is a synthetic estrogen that has been prescribed to women for decades to control symptoms of menopause.


Hydrocortisone is a synthetic form of cortisol that is prescribed as a cream for the skin, a drop for eyes or by pill or injection for severe stress reactions such as asthma or back pain.


Cholesterol is the central molecule used by the body to build sex and adrenal hormones.

Bio-Identical Hormones

A bio-identical hormone is chemically the same as a hormone produced in the body. They are made by transforming plant or animal compounds into molecules that are chemically identical to those produced by human glands.


Note that bio-identical hormones are in fact synthetic in that they are manufactured in a laboratory. Any claim that they are “natural” is fallacious. Plants do not make human hormones. It takes the intervention of chemistry. Because it is manufactured from a plant source makes it no more “natural” than white sugar. White sugar is a refined product from sugar cane or sugar beets. It is refined in a manufacturing plant, not nature. Extracting a compound from a plant and changing its molecular structure to be bio-identical with human hormones is a synthetic process.



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